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International Orthopaedics

, Volume 36, Issue 3, pp 553–558 | Cite as

A five to seven year follow-up comparing computer-assisted vs freehand TKR with regard to clinical parameters

  • C. Lüring
  • M. Kauper
  • H. Bäthis
  • L. Perlick
  • J. Beckmann
  • J. Grifka
  • M. Tingart
  • B. Rath
Original Paper

Abstract

Purpose

Computer-assisted knee surgery has become established in routine clinical practice. Still, there is no study investigating midterm clinical outcome after five to seven years postoperatively. We aimed to test the hypothesis that there is no difference either for subjective [Western Ontario and McMaster Universities (WOMAC) scores] or for objective (Knee Society Score, degree of flexion) criteria between computer-assisted total knee replacement (TKR) and freehand TKR after 5.6–7.3 years.

Methods

We performed a matched-pair analysis; 100 patients who received a primary TKR were investigated after a median follow-up of 6.25 years. Group A was operated on with the support of a computer system, while surgery on patients in group B was performed with the freehand technique. We determined WOMAC Score, Knee Society Score and degree of flexion.

Results

Overall we found similar results for WOMAC Score [group A: 42.98 (SD 13.80); group B: 41.54 (SD 15.01; p = 0.62)], Knee Society Score [group A: 168.20 (SD 21.94); group B: 166.60 (SD 21.44; p = 0.71)] and range of motion [group A: 106° (SD 9.19); group B 107° (SD 7.44; p = 0.62)].

Conclusions

No significant differences in midterm clinical outcome were found after TKR performed in the freehand vs computer-assisted technique.

Keywords

Total Knee Arthroplasty Total Knee Replacement Mechanical Axis Knee Society Score Knee Score 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

We thank BrainLAB and DePuy for providing the navigation system.

Conflict of interest

The first author is a member of the professional training team of Johnson & Johnson.

References

  1. 1.
    Glant TT, Jacobs JJ (1994) Response of three murine macrophage populations to particulate debris: bone resorption in organ cultures. J Orthop Res 12:720–731PubMedCrossRefGoogle Scholar
  2. 2.
    Rodriguez JA, Bhende H, Ranawat CS (2001) Total condylar knee replacement: a 20-year followup study. Clin Orthop Relat Res 388:10–17PubMedCrossRefGoogle Scholar
  3. 3.
    Sharkey PF, Hozack WJ, Rothman RH, Shastri S, Jacoby SM (2002) Insall Award paper. Why are total knee arthroplasties failing today? Clin Orthop Relat Res 404:7–13PubMedCrossRefGoogle Scholar
  4. 4.
    Chen FS, Scher DM, Clancy RM, Vera-Yu A, Di Cesare PE (1999) In vitro and in vivo activation of polymorphonuclear leukocytes in response to particulate debris. J Biomed Mater Res 48:904–912PubMedCrossRefGoogle Scholar
  5. 5.
    Font-Rodriguez DE, Scuderi GR, Insall JN (1997) Survivorship of cemented total knee arthroplasty. Clin Orthop Relat Res 345:79–86PubMedCrossRefGoogle Scholar
  6. 6.
    Jacobs JJ, Gilbert JL, Urban RM (1998) Corrosion of metal orthopaedic implants. J Bone Joint Surg Am 80:268–282PubMedGoogle Scholar
  7. 7.
    Kubo T, Sawada K, Hirakawa K, Shimizu C, Takamatsu T, Hirasawa Y (1999) Histiocyte reaction in rabbit femurs to UHMWPE, metal, and ceramic particles in different sizes. J Biomed Mater Res 45:363–369PubMedCrossRefGoogle Scholar
  8. 8.
    Woolson ST, Northrop GD (2004) Mobile- vs. fixed-bearing total knee arthroplasty: a clinical and radiologic study. J Arthroplasty 19:135–140PubMedCrossRefGoogle Scholar
  9. 9.
    Petersen TL, Engh GA (1988) Radiographic assessment of knee alignment after total knee arthroplasty. J Arthroplasty 3:67–72PubMedCrossRefGoogle Scholar
  10. 10.
    Mahaluxmivala J, Bankes MJ, Nicolai P, Aldam CJH, Allen PW (2001) The effect of surgeon experience on component positioning in 673 press fit condylar posterior cruciate-sacrificing total knee arthroplasties. J Arthroplasty 16:635–640PubMedCrossRefGoogle Scholar
  11. 11.
    Delp SL, Stulberg SD, Davies B, Picard F, Leitner F (1998) Computer assisted knee replacement. Clin Orthop Relat Res 354:49–56PubMedCrossRefGoogle Scholar
  12. 12.
    Laskin RS (2003) Instrumentation pitfalls: you just can’t go on autopilot! J Arthroplasty 18:18–22PubMedCrossRefGoogle Scholar
  13. 13.
    Novotny J, Gonzalez MH, Amirouche FM, Li YC (2001) Geometric analysis of potential error in using femoral intramedullary guides in total knee arthroplasty. J Arthroplasty 16:641–647PubMedCrossRefGoogle Scholar
  14. 14.
    Reed SC, Gollish J (1997) The accuracy of femoral intramedullary guides in total knee arthroplasty. J Arthroplasty 12:677–682PubMedCrossRefGoogle Scholar
  15. 15.
    Bäthis H, Perlick L, Tingart M, Lüring C, Zurakowski D, Grifka J (2004) Alignment in total knee arthroplasty. A comparison of computer-assisted surgery with the conventional technique. J Bone Joint Surg Br 86(5):682–687PubMedCrossRefGoogle Scholar
  16. 16.
    Bauwens K, Matthes G, Wich M, Gebhard F, Hanson B, Ekkernkamp A, Stengel D (2007) Navigated total knee replacement. A meta-analysis. J Bone Joint Surg Am 89(2):261–269PubMedCrossRefGoogle Scholar
  17. 17.
    Bolognesi M, Hofmann A (2005) Computer navigation versus standard instrumentation for TKA: a single-surgeon experience. Clin Orthop Relat Res 440:162–169PubMedCrossRefGoogle Scholar
  18. 18.
    Jenny JY, Clemens U, Kohler S, Kiefer H, Konermann W, Miehlke RK (2005) Consistency of implantation of a total knee arthroplasty with a non-image-based navigation system: a case-control study of 235 cases compared with 235 conventionally implanted prostheses. J Arthroplasty 20:832–889PubMedCrossRefGoogle Scholar
  19. 19.
    Kamat YD, Aurakzai KM, Adhikari AR, Matthews D, Kalairajah Y, Field RE (2009) Does computer navigation in total knee arthroplasty improve patient outcome at midterm follow-up? Int Orthop 33(6):1567–1570PubMedCrossRefGoogle Scholar
  20. 20.
    Lüring C, Oczipka F, Perlick L, Tingart M, Grifka J, Bäthis H (2009) Two year follow-up comparing computer assisted versus freehand TKR on joint stability, muscular function and patients satisfaction. Knee Surg Sports Traumatol Arthrosc 17(3):228–232PubMedCrossRefGoogle Scholar
  21. 21.
    Martin A, von Strempel A (2006) Two year outcomes of computed tomography-based and computed tomography free navigation for total knee arthroplasties. Clin Orthop Relat Res 449:275–282PubMedGoogle Scholar
  22. 22.
    Molfetta L, Caldo D (2008) Computer navigation versus conventional implantation for varus knee total arthroplasty: a case-control study at 5 years follow-up. Knee 15(2):75–79PubMedCrossRefGoogle Scholar
  23. 23.
    Bellamy N, Campbell J, Stevens J, Pilch L, Stewart C, Mahmood Z (1997) Validation study of a computerized version of the Western Ontario and McMaster Universities VA 3.0 Osteoarthritis Index. J Rheumatol 24(12):2413–2415PubMedGoogle Scholar
  24. 24.
    Insall JN, Dorr LD, Scott R, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14PubMedGoogle Scholar
  25. 25.
    Bachmeier C, March L, Cross M, Lapsley H, Tribe K, Courtenay BG et al (2001) A comparison of outcomes in osteoarthritis patients undergoing total hip and knee replacement surgery. Osteoarthritis Cartilage 9:137–146PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • C. Lüring
    • 1
  • M. Kauper
    • 2
  • H. Bäthis
    • 3
  • L. Perlick
    • 4
  • J. Beckmann
    • 2
  • J. Grifka
    • 2
  • M. Tingart
    • 1
  • B. Rath
    • 1
  1. 1.Department of Orthopaedic SurgeryUniversity of AachenAachenGermany
  2. 2.Department of Orthopaedic SurgeryUniversity of RegensburgRegensburgGermany
  3. 3.Department of Trauma SurgeryMerheim Medical CenterCologneGermany
  4. 4.Paulinen Klinik WiesbadenWiesbadenGermany

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