Computer-navigated versus conventional one-stage bilateral total knee arthroplasty

doi:10.3969/j.issn.2095-4344.3866

Abstract

Abstract: BACKGROUND: Failure of total knee arthroplasty is mainly related to the poor prosthesis position, bad lower limbs alignment and imbalanced soft tissue. However, conventional total knee arthroplasty is difficult to achieve high accuracy, repeatability and personalized operation, because it relies too much on the experience and visual inspection of the surgeon.
OBJECTIVE: To explore the early clinical efficacy between computer-navigated and conventional total knee arthroplasties under one-stage bilateral surgery.
METHODS: Totally 21 patients (42 knees) with knee arthritis, who were treated with one-stage bilateral total knee arthroplasty in Department of Orthopedics, the First Affiliated Hospital of Soochow University from June to December 2019, were prospectively enrolled in this study. The patients randomly underwent computer-navigated total knee arthroplasty for one knee and conventional total knee arthroplasty for the contralateral knee. The duration of operation, length of incision, and drainage volume were compared between the two sides. Lower limb alignment hip-knee-ankle angle α, deviation of goal alignment, mechanical lateral distal femoral angle β, sagittal femoral component angle δ, medial proximal tibial angle γ, tibial posterior slope angle ε, femoral-patella angle Q, and femoral notching were compared between the two sides after operation. Hospital for Special Surgery score, Western Ontario and McMaster Universities Osteoarthritis Index score at 3, 14 days, 1, 3, and 6 months, Forgotten Joint Score at 6 months, patients’ satisfaction, and complications were compared between the two sides. The clinical trial was registered in Chinese Clinical Trial Registry with the registration number of ChiCTR2000033499.
RESULTS AND CONCLUSION: (1) The duration of operation in navigation group (88.95±15.45) minutes was longer compared with conventional group (78.25±13.83) minutes (P < 0.05). The incision length in the navigation group (15.08±0.86) cm was longer than that in the conventional group (13.44±0.86) cm (P < 0.05). (2) Both groups obtained good results of prosthetic position, while the navigation group achieved less deviation of goal alignment compared with conventional group (P < 0.05). In patients with a preoperative mechanical axis deviation of >15°, the reconstructed alignment was more precise in navigation group (P < 0.05). (3) The Hospital for Special Surgery score at 3 and 6 months was higher in the navigation group compared with the conventional group (P < 0.05). There was no statistically significant difference in Hospital for Special Surgery score, Western Ontario and McMaster Universities Osteoarthritis Index score, and Forgotten Joint Score between the two groups during the rest follow-up (P > 0.05). (4) The results confirmed that computer-navigated total knee arthroplasty obtained more accurate goal alignment compared with the conventional total knee arthroplasty, especially for those who had severe lower limb deformities before surgery, and showed certain early functional advantages. However, the duration of operation and length of incision were prolonged in computer-navigated total knee arthroplasty.

Key words: computer navigation, knee, arthroplasty, one-stage bilateral, osteoarthritis, lower limb alignment

CLC Number:

Zheng Kai, Li Rongqun, Sun Houyi, Zhang Weicheng, Li Ning, Zhou Jun, Zhu Feng, Wang Yijun, Xu Yaozeng. Computer-navigated versus conventional one-stage bilateral total knee arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(21): 3305-3312.

Figures/Tables 10

References

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