Abstract
ABSTRACTObjective It is difficult to achieve proper alignment after total knee arthroplasty (TKA) in patients with extra-articular deformity (EAD) because of altered anatomical axis and distorted landmarks. As of this writing, only case series have been reported with regard to the usefulness of computer-assisted navigation systems for TKA with EAD. This study therefore compared outcomes in TKA with EAD, with and without navigation.Methods Fourteen osteoarthritis patients with EAD due to previous fracture malunion or operations were assessed. Seven TKAs were performed with navigation (navigation group) and another 7 were performed without navigation (manual group). Clinical and radiographic outcomes were compared before and two years after surgery.Results The mean postoperative Knee Society function score was significantly higher in the navigation group. No significant difference was found in postoperative range of motion and Knee Society knee score. The rate of outliers in radiographic outcomes tended to be lower in the navigation group.Conclusion Better clinical outcomes were achieved in cases in which navigation was used. Computer-assisted navigation is useful in TKA for patients with EAD. Level of Evidence III; Case control study.
Highlights
Total knee arthroplasty (TKA) is a successful surgical procedure for patients with end-stage osteoarthritis (OA)
Knee Society knee score (KSKS) improved from 58.9±9.2 points before surgery to 93.3±6.9 points at the last follow-up in the navigation group, while it improved from 47.0±18.4 points to 93.7±4.1 points in the manual group
Knee Society function score (KSFS) improved from 56.6±10.8 points before surgery to 93.3±5.9 points at the last follow-up in the navigation group, while it improved from 49.7±27.8 points to 73.6±15.4 points in the manual group
Summary
Total knee arthroplasty (TKA) is a successful surgical procedure for patients with end-stage osteoarthritis (OA). Computer-assisted surgery has been used for over 10 years to assist in the placement of cutting guides, instruments, and implants, and was developed to overcome some limitations of standard mechanical instrumentation.[3] Several comparative studies have revealed that computer-assisted surgery was effective in TKA to reduce mechanical axis outliers after surgery, and this procedure is used widely.[4,5,6,7] Ishida et al.[8] reported better objective outcomes from use of a navigation system over conventional procedures, including range of motion (ROM) and radiological assessment at 5 years after TKA.
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