Document Detail

Computer-assisted total knee arthroplasty is currently of no proven clinical benefit: a systematic review.
MedLine Citation:
PMID:  22948522     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Navigated total knee arthroplasty (TKA) may improve coronal alignment outliers; however, it is unclear whether navigated TKA improves the long-term clinical results of TKA.
QUESTIONS/PURPOSES: Does the literature contain evidence of better long-term function and lower revision rates with navigated TKA compared with conventional TKA?
METHODS: A systematic literature review was conducted of navigated TKA reviewing articles related to coronal alignment, clinical knee and function scores, cost, patient satisfaction, component rotation, anteroposterior and mediolateral stability, complications, and longer-term reports.
RESULTS: Coronal plane alignment is improved with navigated TKA with fewer radiographic outliers. We found limited evidence of improvements in any other variable, and function was not improved. The duration of surgery is increased and there are unique complications related to navigated TKA. The long-term benefits of additional increase in accuracy of alignment are not supported by any current evidence.
CONCLUSIONS: The findings in reports of navigated TKA should be interpreted with caution. There are few short- and medium- and no long-term studies demonstrating improved clinical outcomes using navigated TKA. Despite substantial research, contradictory findings coupled with reservations about the cost and efficacy of the technology have contributed to the failure of computer navigation to become the accepted standard in TKA. Longer-term studies demonstrating improved function, lower revision rates, and acceptable costs are required before navigated TKA may be widely adopted. In the future, with improvements in study design, methodology, imaging, navigation technology, newer functional outcome tools, and longer-term followup studies, we suspect that navigated TKA may demonstrate yet unrecognized benefits.
R Stephen J Burnett; Robert L Barrack
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  471     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-24     Completed Date:  2013-05-28     Revised Date:  2014-01-09    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  264-76     Citation Subset:  AIM; IM    
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MeSH Terms
Arthroplasty, Replacement, Knee / methods*
Knee Joint / surgery*
Surgery, Computer-Assisted / methods*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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