Computer Navigation-assisted versus Minimally Invasive TKA

作者：Peter M. Bonutti, Daniel A. Dethmers, Slif Dagobert Ulrich, Thorsten Markus Seyler, Michael A. Mont · 发表于：Clinical Orthopaedics and Related Research · 年份：2008 · DOI：10.1007/s11999-008-0429-7 · 被引用次数：58 · 研究领域：Total Knee Arthroplasty Outcomes、Orthopaedic implants and arthroplasty、Orthopedic Infections and Treatments

UNLABELLED: Computer-navigated and minimally invasive TKAs are emerging technologies that have distinct strengths and weaknesses. We compared duration of surgery, length of hospitalization, Knee Society scores, radiographic alignments, and complications in two unselected groups of 81 consecutive knees that underwent TKA using either a minimally invasive approach or computer navigation. The two groups were operated on by two different surgeons over differing timeframes. The mean surgical time was longer in the navigated group by 63 minutes. The Knee Society scores and lengths of hospitalization of the two groups were similar. The postoperative component alignments of the two groups were similar; the mean femoral valgus and tibial varus angles of the navigation group changed from 96 degrees and 88 degrees preoperatively to 95 degrees and 89 degrees postoperatively, respectively, and in the minimally invasive group, the mean femoral valgus angles and tibial varus angles changed from 97 degrees and 88 degrees preoperatively to 95 degrees and 89 degrees postoperatively, respectively. There were 11 major and three minor complications in the navigation group, including one revision, two femoral shaft fractures, four reoperations for knee stiffness, and four instances of bleeding from tracker sites. We believe the higher incidence of complications in addition to the longer operative time in the navigated group may outweigh any potential radiographic benefits. LEVEL OF EVIDENCE: Level...