Abstract
BackgroundNavigation was introduced into total knee arthroplasty (TKA) to improve accuracy of component position, function and survival of implants. This study was designed to assess the outcome of navigated TKA in comparison with conventional implantation with the focus on rotational component position and clinical mid-term results.MethodsIn a prospectively randomized single-blinded approach, 90 patients with primary gonarthrosis were assigned to three different groups. Thirty patients each were assigned to NexGen LPS without and with navigation (groups 1 and 2), and 30 patients to navigation with the Stryker Scorpio PS (group 3). The navigation system used was the imageless Stryker KneeTrac, version 1.0. Clinical outcome was assessed by a blinded observer applying the Knee Society Score (KSS) and a visual analogue scale (VAS) for pain. CT scans and radiographs were conducted prior to and 12 weeks after index surgery.ResultsSeventy-nine patients were available for clinical evaluation at 3 ± 0.4 years follow-up. Four implants had to be revised for early loosening or infection (4.4%). Four patients had died and three patients were not able to follow the invitation for clinical assessment. Functional results in the KSS were significantly lower after navigated TKA. Operation time and incisions with navigation were significantly longer. Significantly less radiological outliers with navigation were found for coronal alignment of the femur, only.ConclusionIn this series, no beneficial effect for navigation in TKA could be shown assessing clinical data, as functional results in the presented series seemed to be lower after first generation navigated TKA. The clinical mid- to long-term value of navigation remains to be evaluated in larger patient series or meta-analyses at longer follow-up.Trial registration numberDRKS 00000430
Highlights
Navigation was introduced into total knee arthroplasty (TKA) to improve accuracy of component position, function and survival of implants
Navigation of TKA may be performed based on computed tomography (CT)-scans or image-free at equal radiological results [7]
Choong et al reported on mean values of femoral rotation as measured on full-leg CT scans, which were not different between conventional and navigated TKA but did not mention, if rotational outliers could be reduced [11]
Summary
Navigation was introduced into total knee arthroplasty (TKA) to improve accuracy of component position, function and survival of implants. Navigation of TKA may be performed based on CT-scans or image-free at equal radiological results [7]. Today it finds its application in numerous orthopedic interventions. Navigation was successfully introduced into TKA to improve radiological accuracy of component position by avoiding position outliers in coronal and sagittal planes [8]. In this sense it has been proven an effective tool [9,10]. Choong et al reported on mean values of femoral rotation as measured on full-leg CT scans, which were not different between conventional and navigated TKA but did not mention, if rotational outliers could be reduced [11]
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