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Research Casts Doubt on Computer-Aided Knee Surgery

The Journal of Bone and Joint Surgery (JBJS) has published new research that suggests there is no difference in knee function after conventional total knee arthroplasties (TKAs) and those aided by computers. It generally has been accepted that computer-aided procedures provide improved positioning, sizing and alignment of replacement knee joints, presumably resulting in greater joint durability and an improvement in patient mobility.

Researches in South Korea compared the results of 520 osteoarthritic patients who underwent computer-navigated TKA for one knee and conventional TKA for the other knee. Patients included 452 women (904 knees) and 68 men (136 knees). Patients were assessed before surgery, and then at three months and one year following surgery, and annually thereafter, for 10 to 12 years. Patients were assessed clinically using the Knee Society rating system and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and radiographically using X-rays or computed tomography scans.

No statistically significant differences were noted between the computer-navigated and traditional procedure scores pertaining to knee function, pain, knee motion and activity, according to the study. In addition, the Knee Society and WOMAC scores were comparable for both procedures.

“Our mid-term follow-up data demonstrated no difference in clinical function or alignment and survivorship of the components between the knees that underwent computer-navigated total knee arthroplasty and those that underwent conventional total knee arthroplasty,” said Young-Hoo Kim, M.D., of The Joint Replacement Center, Ewha Woman’s University School of Medicine in Seoul, Korea.

Survivorship of the implants at 10.8 years (the mean assessment duration) after the operation was not significantly different: 98.8 percent in the computer-navigated TKA group, and 99.2 percent in the conventional TKA group. The length of the incision, the intra-operative blood loss, the duration and volume of drainage, and the transfusion volume were not significantly different between the two groups. The mean operative time and time during which the surgeons used a tourniquet were significantly longer in the computer-navigated TKA group than in the conventional TKA group.

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