Meyer, Matthias and Renkawitz, Tobias and Voellner, Florian and Benditz, Achim and Grifka, Joachim and Weber, Markus (2021) Pros and cons of navigated versus conventional total knee arthroplasty-a retrospective analysis of over 2400 patients. ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, 141 (11). pp. 1983-1991. ISSN 0936-8051, 1434-3916
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Introduction Because of the ongoing discussion of imageless navigation in total knee arthroplasty (TKA), its advantages and disadvantages were evaluated in a large patient cohort. Methods This retrospective analysis included 2464 patients who had undergone TKA at a high-volume university arthroplasty center between 2012 and 2017. Navigated and conventional TKA were compared regarding postoperative mechanical axis, surgery duration, complication rates, one-year postoperative patient-reported outcome measures (PROMs) (WOMAC and EQ-5D indices), and responder rates as defined by the criteria of the Outcome Measures in Rheumatology and Osteoarthritis Research Society International consensus (OMERACT-OARSI). Results Both navigated (1.8 +/- 1.6 degrees) and conventional TKA (2.1 +/- 1.6 degrees, p = 0.002) enabled the exact reconstruction of mechanical axis. Surgery duration was six minutes longer for navigated TKA than for conventional TKA (p < 0.001). Complication rates were low in both groups with comparable frequencies: neurological deficits (p = 0.39), joint infection (p = 0.42 and thromboembolic events (p = 0.03). Periprosthetic fractures occurred more frequently during conventional TKA (p = 0.001). One-year PROMs showed excellent improvement in both groups. The WOMAC index was statistically higher for navigated TKA than for conventional TKA (74.7 +/- 19.0 vs. 71.7 +/- 20.7, p = 0.014), but the increase was not clinically relevant. Both groups had a similarly high EQ-5D index (0.23 +/- 0.24 vs. 0.26 +/- 0.25, p = 0.11) and responder rate (86.5% [256/296] vs. 85.9% [981/1142], p = 0.92). Conclusion Both methods enable accurate postoperative leg alignment with low complication rates and equally successful PROMs and responder rates one year postoperatively.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ; Total knee arthroplasty; Navigation; Alignment; Outcome; Complications; Responder |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Orthopädie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 12 Sep 2022 11:46 |
| Last Modified: | 12 Sep 2022 11:46 |
| URI: | https://pred.uni-regensburg.de/id/eprint/47188 |
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