No differences in mid- to long-term outcomes of computer-assisted navigation versus conventional total knee arthroplasty
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KNEE
No differences in mid‑ to long‑term outcomes of computer‑assisted navigation versus conventional total knee arthroplasty Dong‑Yeong Lee1 · Young‑Jin Park2 · Sun‑Chul Hwang2 · Jin‑Sung Park2 · Dong‑Geun Kang3 Received: 3 January 2019 / Accepted: 19 November 2019 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019
Abstract Purpose Accurate implant position in total knee arthroplasty (TKA) can potentially lead to better long-term functional outcomes and implant survival. Recent studies on whether better clinical results could be obtained from computer-navigated or conventional TKA were inconclusive. In addition, recent reviews only included short-term follow-up studies without performing quantitative mid- to long-term follow-up analysis. Thus, the purpose of the present study was to perform a meta-analysis comparing mid- to long-term clinical outcomes (such as knee scoring and functional results) and radiological outcomes (such as normal alignment of the limb axis or component) between computer-navigated TKA and conventional TKA to determine which method of TKA could obtain better clinical and radiological results. Methods MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and SCOPUS electronic databases were searched for relevant articles published through August 2018 that compared outcomes of computer-navigated TKA and conventional TKA. Data search, extraction, analysis, and quality assessment were performed according to the Cochrane Collaboration guidelines. Clinical and radiological outcomes of both techniques were evaluated using various outcome measures. Results Seven randomized controlled trials were included. Based on Knee Society Scores, the Western Ontario and McMaster Universities Osteoarthritis Index, pain, and range of motion, there were no significant differences in clinical outcomes between the two techniques. Based on outliers from the normal axis, outliers of femoral components in the coronal plane, and outliers of tibial components in the coronal plane, radiologic outcomes showed no significant differences between the two techniques either. Conclusions The present study revealed that there were no significant differences in clinical or radiological outcomes between computer-navigated TKA and conventional TKA. It remains unclear which TKA technique yields better results in terms of mid- to long-term clinical and radiological outcomes. Level of evidence I. Keywords Total knee arthroplasty · Knee surgery · Computer-assisted surgery · Navigation · Conventional · Meta-analysis
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00167-019-05808-5) contains supplementary material, which is available to authorized users. * Dong‑Geun Kang [email protected] 1
Armed Forces Daegu Hospital, Daegu, Republic of Korea
Department of Orthopaedic Surgery and Institute of Health Science, Gyeongsang National University School of Medicine, Gyeongsang National Universi
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