Abstract
Introduction
Navigation technique for total knee replacement has been shown to improve accuracy of prosthesis alignment in several studies. The purpose was to compare the patient-reported outcome measures in primary total knee replacement (TKR) using navigation versus conventional surgical technique at 1- and 2-year follow-up.
Materials and methods
A retrospective review of prospectively collected patient-reported outcome data for 351 consecutively performed primary TKR was included in the study. The study group (N = 113) included patients who had Triathlon TKR using articular surface mounted (ASM Stryker®) navigation technique and control group (N = 238) included patients who had Triathlon TKR using conventional jig. In addition to the WOMAC (Western Ontario and McMaster University Osteoarthritis Index) and SF-36 (Medical Outcomes Trust Short Form-36), a short self-report questionnaire evaluating the level of satisfaction, quality of life and whether patients would undergo knee replacement again.
Results
WOMAC: no significant difference between the groups was noted in mean WOMAC pain, function and stiffness scores at 1- and 2-year follow-up. SF-36: no significant difference between the groups was seen except in the physical function component of score at 1 year (p = 0.019). Navigation group mean 56.78 (CI 51.06–62.5) versus conventional group mean 48.34 (44.68–52.01) but this difference was not observed at 2-year follow-up.
Conclusions
The overall patient-reported outcome scores improved after total knee replacement but appear to be comparable in both groups at 1- and 2-year follow-up.
Similar content being viewed by others
References
Siston RA, Giori NJ, Goodman SB, Delp SL (2007) Surgical navigation for total knee arthroplasty: a perspective. J Biomech 40(4):728–735
Stulberg SD, Loan P, Sarin V (2002) Computer-assisted navigation in total knee replacement: results of an initial experience in thirty-five patients. J Bone Joint Surg Am 84-A(Suppl 2):90–98
Bellamy N, Buchanan WW et al (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15(12):1833–1840
Ware JE Jr, Sherbourne CD (1992) The MOS 36-Item Short-Form Health Survey (SF-36): I. Conceptual framework and item selection. Med Care 30(6):473–483
Escobar A, Quintana JM et al (2007) Responsiveness and clinically important differences for the WOMAC and SF-36 after total knee replacement. Osteoarthr Cartil 15(3):273–280
Mahomed N, Gandhi R, Daltroy L, Katz JN (2011) The self-administered patient satisfaction scale for primary hip and knee arthroplasty. Arthritis 2011:591253
Australian joint registry 2013 report. https://aoanjrr.dmac.adelaide.edu.au/documents/10180/127202/Annual%20Report%202013?version=1.2&t=1385685288617
National joint registry 2014 report. http://www.njrcentre.org.uk/njrcentre/Portals/0/Documents/England/Reports/11th_annual_report/NJR%2011th%20Annual%20Report%202014.pdf
Swedish knee arthroplasty register 2013 report. http://www.myknee.se/pdf/SKAR2013_Eng.pdf
Anderson KC, Buehler KC, Markel DC (2005) Computer assisted navigation in total knee arthroplasty: comparison with conventional methods. J Arthroplast 20(Suppl):132–138
Chauhan SK, Clark GW, Lloyd S, Scott RG, Breidahl W, Sikorski JM (2004) Computer-assisted total knee replacement. A controlled cadaver study using a multi-parameter quantitative CT assessment of alignment (the Perth CT protocol). J Bone Joint Surg Br 86(6):818–823
Rosenberger RE, Hoser C, Quirbach S, Attal R, Hennerbichler A, Fink C (2008) Improved accuracy of component alignment with the implementation of image-free navigation in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 16(3):249–257
Decking R, Markmann Y, Fuchs J, Puhl W, Scharf HP (2005) Leg axis after computer-navigated total knee arthroplasty: a prospective randomized trial comparing computer-navigated and manual implantation. J Arthroplast 20(3):282–288
Chauhan SK, Scott RG, Breidahl W, Beaver RJ (2004) Computer-assisted knee arthroplasty versus a conventional jig-based technique: a randomised, prospective trial. J Bone Joint Surg Br 89-B:327–377
Ritter MA, Davis KE, Meding JB, Pierson JL, Berend ME, Malinzak RA (2011) The effect of alignment and BMI on failure of total knee replacement. J Bone Joint Surg Am 93(17):1588–1596
Matziolis G, Krocker D, Weiss U, Tohtz S, Perka C (2007) A prospective, randomized study of computer-assisted and conventional total knee arthroplasty. Three-dimensional evaluation of implant alignment and rotation. J Bone Joint Surg Am 89(2):236–243
Parratte S, Pagnano MW, Trousdale RT, Berry DJ (2010) Effect of postoperative mechanical axis alignment on the 15-year survival of modern, cemented total knee replacements. J Bone Joint Surg Am 92:2143–2149
Kim YH, Park JW, Kim JS (2012) Computer-navigated versus conventional total knee arthroplasty a prospective randomized trial. J Bone Joint Surg Am 94(22):2017–2024
Hoffart HE, Langenstein E, Vasak N (2012) A prospective study comparing the functional outcome of computer-assisted and conventional total knee replacement. J Bone Joint Surg Br 94(2):194–199
Pang HN, Yeo SJ, Chong HC, Chin PL, Ong J, Lo NN (2011) Computer-assisted gap balancing technique improves outcome in total knee arthroplasty, compared with conventional measured resection technique. Knee Surg Sports Traumatol Arthrosc 19(9):1496–1503
Cheng T, Pan XY, Mao X, Zhang GY, Zhang XL (2012) Little clinical advantage of computer-assisted navigation over conventional instrumentation in primary total knee arthroplasty at early follow-up. Knee 19(4):237–245
Burnett RS, Barrack RL (2013) Computer-assisted total knee arthroplasty is currently of no proven clinical benefit: a systematic review. Clin Orthop Relat Res 471(1):264–276
Hoppe S, Mainzer JD, Frauchiger L, Ballmer PM, Hess R, Zumstein MA (2012) More accurate component alignment in navigated total knee arthroplasty has no clinical benefit at 5-year follow-up. Acta Orthop 83(6):629–633
Allen CL, Hooper GJ, Oram BJ, Wells JE (2014) Does computer-assisted total knee arthroplasty improve the overall component position and patient function? Int Orthop 38(2):251–257
Lad DG, Thilak J, Thadi M (2013) Component alignment and functional outcome following computer assisted and jig based total knee arthroplasty. Indian J Orthop 47(1):77–82
Harvie P, Sloan K, Beaver RJ (2012) Computer navigation vs conventional total knee arthroplasty: five-year functional results of a prospective randomized trial. J Arthroplast 27(5):667.e1–672.e1
Hernández-Vaquero D, Suarez-Vazquez A, Iglesias-Fernandez S (2011) Can computer assistance improve the clinical and functional scores in total knee arthroplasty? Clin Orthop Relat Res 469(12):3436–3442
Ballas R, Philippot R, Cartier JL, Boyer B, Farizon F (2013) Computer-assisted total knee arthroplasty: impact of the surgeon’s experience on the component placement. Arch Orthop Trauma Surg 133(3):397–403
Kalairajah Y, Simpson D, Cossey AJ, Verrall GM, Spriggins AJ (2005) Blood loss after total knee replacement: effects of computer assisted surgery. J Bone Joint Surg Br 87:1480–1482
Hinarejos P, Corrales M, Matamalas A, Bisbe E, Cáceres E (2009) Computer-assisted surgery can reduce blood loss after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 17(4):356–360
Kini SG, Sathappan SS (2013) Role of navigated total knee arthroplasty for acute tibial fractures in the elderly. Arch Orthop Trauma Surg 133(8):1149–1154
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Singisetti, K., Muthumayandi, K., Abual-Rub, Z. et al. Navigation-assisted versus conventional total knee replacement: no difference in patient-reported outcome measures (PROMs) at 1 and 2 years. Arch Orthop Trauma Surg 135, 1595–1601 (2015). https://doi.org/10.1007/s00402-015-2314-7
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00402-015-2314-7