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Conventional versus computer-assisted surgery in total knee arthroplasty: comparison at ten years follow-up

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Abstract

Purpose

Computer-assisted systems (CAS) for total knee arthroplasty (TKA) were expected to result in more accurate prosthesis implantation, better patient outcomes, and longer implant survival when compared to conventional instrumentation (CI). The aim of this study was to compare two groups of patients operated using CAS or CI at ten years follow-up.

Methods

One hundred twenty TKA patients, 60 using CAS and 60 using CI, were contacted after a decade for follow-up. Eligible patients received radiological examination to assess the lower-limb mechanical axis. They were also clinically assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Knee Society Score for Knee (KSS-K) and Function (KSS-F) Scoring. Kaplan-Meier survival analysis was performed to assess revisions, not for post-traumatic reasons.

Results

In CAS and CI groups, the lower-limb mechanical axis was 1.7° ± 2.4° and 1.5° ± 2.8°, respectively; corresponding KOOS values were 82.3 ± 14.3 and 78.6 ± 14.4; KSS-K values were 85.9 ± 11.1 and 85.0 ± 9.7; KSS-F values were 82.2 ± 19.3 and 83.8 ± 18. For these assessments, the differences between the two groups were not statistically significant (p > 0.05). Two CAS (3.8%) and three CI patients (5.7%) were revised. The Kaplan-Meier analysis showed no significant differences between the two groups.

Conclusions

No significant differences were found at long-term follow-up in terms of radiographical-clinical outcomes and of implant survival between TKA operated using CAS or CI.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, Italy

    Michele d’Amato, Andrea Ensini, Paolo Barbadoro & Andrea Illuminati

  2. Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, Italy

    Andrea Ensini, Alberto Leardini & Claudio Belvedere

  3. Movement Analysis Laboratory and Functional-Clinical Evaluation of Prostheses, Centro di Ricerca Codivilla-Putti, Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, Italy

    Claudio Belvedere

Authors
  1. Michele d’Amato
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  2. Andrea Ensini
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  3. Alberto Leardini
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  4. Paolo Barbadoro
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  5. Andrea Illuminati
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  6. Claudio Belvedere
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Correspondence to Claudio Belvedere.

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d’Amato, M., Ensini, A., Leardini, A. et al. Conventional versus computer-assisted surgery in total knee arthroplasty: comparison at ten years follow-up. International Orthopaedics (SICOT) 43, 1355–1363 (2019). https://doi.org/10.1007/s00264-018-4114-5

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  • DOI: https://doi.org/10.1007/s00264-018-4114-5

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