Computer Navigation-Assisted Knee Replacement Demonstrates Improved Outcome Compared with Conventional Knee Replacement at Mid-Term Follow-up: A Systematic Review and Meta-analysis

Overview

Journal Indian J Orthop

Publisher Springer Nature

Specialty Orthopedics

Date 2020 Nov 2

PMID 33133398

Citations 5

Authors

Charles Ayekoloye

Osondu Nwangwu

Temitope Alonge

Affiliations

Soon will be listed here.

Abstract

The study is a systematic review and meta-analysis of prospective randomised control studies and prospective cohort studies of mid-term functional outcome of total knee replacement undertaken using imageless computer navigation compared with conventional instrumented total knee replacement. The literature search strategy included a search of the electronic databases, visual scanning of reference lists, hand searching of key journals and conference proceedings, and abstracts, citations, and trial registers. In total, 440 papers were retrieved after removal of duplicates, and with further screening, 11 papers were included in the systematic review and 6 papers were considered appropriate for meta-analysis. Analysis of the data showed evidence of a modest improvement in functional outcome at mid-term follow-up with use of imageless computer navigation assistance compared with conventional instrumented total knee replacement with a total score point estimate of 3.36 confidence interval (CI) (- 0.583, 7.298), objective score point estimate of 1.45 CI (0.11, 2.799), and functional score point estimate of 2.4, CI (- 1.174, 5.977). The predominant risk of bias was from random allocation and attrition. There is evidence of a modest improvement in functional outcome with the use of imageless computer navigation assistance compared with conventional instrumented total knee replacement at mid-term follow-up.

Citing Articles

[Future implications of navigation in total knee arthroplasty].

Bathis H, Kappel P, Pfeiffer T, Frohlich M, Caspers M, Ates D Orthopadie (Heidelb). 2022; 51(9):708-718.

PMID: 35997798 DOI: 10.1007/s00132-022-04285-y.

After 25 years of computer-navigated total knee arthroplasty, where do we stand today?.

Shah S Arthroplasty. 2022; 3(1):41.

PMID: 35236503 PMC: 8796491. DOI: 10.1186/s42836-021-00100-9.

Combined quadriceps tendon reconstruction and total knee replacement with computer navigation: a case report.

Abdulkareem I, Liu P, Adhikhari A, Kader D J Med Case Rep. 2022; 16(1):42.

PMID: 35109914 PMC: 8810210. DOI: 10.1186/s13256-022-03265-2.

[Short-term effectiveness of novel computer navigation system assisted total knee arthroplasty].

Tang Q, Zhou Y, Guo S, Deng W, Wang Z Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021; 35(10):1281-1285.

PMID: 34651481 PMC: 8505941. DOI: 10.7507/1002-1892.202105114.

Outcomes of Computer-Assisted Total Knee Arthroplasty Compared to Conventional TKA: A Bicentric Controlled Retrospective Clinical Study.

Zampogna B, Campi S, Torre G, Villari E, Moncada F, Perrino A J Clin Med. 2021; 10(15).

PMID: 34362138 PMC: 8347820. DOI: 10.3390/jcm10153352.

References

Blakeney W, Khan R, Wall S . Computer-assisted techniques versus conventional guides for component alignment in total knee arthroplasty: a randomized controlled trial. J Bone Joint Surg Am. 2011; 93(15):1377-84. DOI: 10.2106/JBJS.I.01321. View

Robertsson O, Dunbar M, Pehrsson T, Knutson K, Lidgren L . Patient satisfaction after knee arthroplasty: a report on 27,372 knees operated on between 1981 and 1995 in Sweden. Acta Orthop Scand. 2000; 71(3):262-7. DOI: 10.1080/000164700317411852 . View

Parvizi J, Nunley R, Berend K, Lombardi Jr A, Ruh E, Clohisy J . High level of residual symptoms in young patients after total knee arthroplasty. Clin Orthop Relat Res. 2013; 472(1):133-7. PMC: 3889453. DOI: 10.1007/s11999-013-3229-7. View

Lehnen K, Giesinger K, Warschkow R, Porter M, Koch E, Kuster M . Clinical outcome using a ligament referencing technique in CAS versus conventional technique. Knee Surg Sports Traumatol Arthrosc. 2010; 19(6):887-92. PMC: 3096770. DOI: 10.1007/s00167-010-1264-4. View

Kim Y, Park J, Kim J . Computer-navigated versus conventional total knee arthroplasty a prospective randomized trial. J Bone Joint Surg Am. 2012; 94(22):2017-24. DOI: 10.2106/JBJS.L.00142. View

Blakeney W, Khan R, Palmer J . Functional outcomes following total knee arthroplasty: a randomised trial comparing computer-assisted surgery with conventional techniques. Knee. 2014; 21(2):364-8. DOI: 10.1016/j.knee.2013.04.001. View

Higgins J, Altman D, Gotzsche P, Juni P, Moher D, Oxman A . The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ. 2011; 343:d5928. PMC: 3196245. DOI: 10.1136/bmj.d5928. View

Cip J, Widemschek M, Luegmair M, Sheinkop M, Benesch T, Martin A . Conventional versus computer-assisted technique for total knee arthroplasty: a minimum of 5-year follow-up of 200 patients in a prospective randomized comparative trial. J Arthroplasty. 2014; 29(9):1795-802. DOI: 10.1016/j.arth.2014.04.037. View

Allen C, Hooper G, Oram B, Wells J . Does computer-assisted total knee arthroplasty improve the overall component position and patient function?. Int Orthop. 2013; 38(2):251-7. PMC: 3923953. DOI: 10.1007/s00264-013-1996-0. View

10.

Jeffery R, Morris R, Denham R . Coronal alignment after total knee replacement. J Bone Joint Surg Br. 1991; 73(5):709-14. DOI: 10.1302/0301-620X.73B5.1894655. View

11.

Ritter M, Davis K, Meding J, Pierson J, Berend M, Malinzak R . The effect of alignment and BMI on failure of total knee replacement. J Bone Joint Surg Am. 2011; 93(17):1588-96. DOI: 10.2106/JBJS.J.00772. View

12.

Schulz K, Altman D, Moher D . CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMC Med. 2010; 8:18. PMC: 2860339. DOI: 10.1186/1741-7015-8-18. View

13.

Bourne R, Chesworth B, Davis A, Mahomed N, Charron K . Patient satisfaction after total knee arthroplasty: who is satisfied and who is not?. Clin Orthop Relat Res. 2009; 468(1):57-63. PMC: 2795819. DOI: 10.1007/s11999-009-1119-9. View

14.

Huang N, Dowsey M, Ee E, Stoney J, Babazadeh S, Choong P . Coronal alignment correlates with outcome after total knee arthroplasty: five-year follow-up of a randomized controlled trial. J Arthroplasty. 2012; 27(9):1737-41. DOI: 10.1016/j.arth.2012.03.058. View

15.

Hoffart H, Langenstein E, Vasak N . A prospective study comparing the functional outcome of computer-assisted and conventional total knee replacement. J Bone Joint Surg Br. 2012; 94(2):194-9. DOI: 10.1302/0301-620X.94B2.27454. View

16.

Burnett R, Barrack R . Computer-assisted total knee arthroplasty is currently of no proven clinical benefit: a systematic review. Clin Orthop Relat Res. 2012; 471(1):264-76. PMC: 3528921. DOI: 10.1007/s11999-012-2528-8. View

17.

Thiengwittayaporn S, Kanjanapiboonwong A, Junsee D . Midterm outcomes of electromagnetic computer-assisted navigation in minimally invasive total knee arthroplasty. J Orthop Surg Res. 2013; 8:37. PMC: 4231448. DOI: 10.1186/1749-799X-8-37. View

18.

Shakespeare D . Conventional instruments in total knee replacement: what should we do with them?. Knee. 2005; 13(1):1-6. DOI: 10.1016/j.knee.2005.06.002. View

19.

Rebal B, Babatunde O, Lee J, Geller J, Patrick Jr D, Macaulay W . Imageless computer navigation in total knee arthroplasty provides superior short term functional outcomes: a meta-analysis. J Arthroplasty. 2013; 29(5):938-44. DOI: 10.1016/j.arth.2013.09.018. View

20.

Xie C, Liu K, Xiao L, Tang R . Clinical Outcomes After Computer-assisted Versus Conventional Total Knee Arthroplasty. Orthopedics. 2012; 35(5):e647-53. DOI: 10.3928/01477447-20120426-17. View