Abstract
Purpose The development of new computer-assisted navigation technologies in total knee arthroplasty
(TKA) has attracted great interest; however, the debate remains open as to the real
reliability of these systems. We compared conventional TKA with last generation computer-navigated
TKA to find out if navigation can reach better radiographic and clinical outcomes.
Methods Twenty patients with tricompartmental knee osteoarthritis were prospectively selected
for conventional TKA (n = 10) or last generation computer-navigated TKA (n = 10). Data regarding age, gender, operated side, and previous surgery were collected.
All 20 patients received the same cemented posterior-stabilized TKA. The same surgical
instrumentation, including alignment and cutting guides, was used for both the techniques.
A single radiologist assessed mechanical alignment and tibial slope before and after
surgery. A single orthopaedic surgeon performed clinical evaluation at 1 year after
the surgery. Wilcoxon's test was used to compare the outcomes of the two groups. Statistical
significance was set at p < 0.05.
Results No significant differences in mechanical axis or tibial slope was found between the
two groups. The clinical outcome was equally good with both techniques. At a mean
follow-up of 15.5 months (range, 13–25 months), all patients from both groups were
generally satisfied with a full return to daily activities and without a significance
difference between them.
Conclusion Our data showed that clinical and radiological outcomes of TKA were not improved
by the use of computer-assisted instruments, and that the elevated costs of the system
are not warranted.
Level of Evidence This is a Level II, randomized clinical trial.
Keywords
total knee arthroplasty - navigation - smart wireless - limb alignment - computer-assisted
