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World class computing and information science research at Strathclyde...

The Strathprints institutional repository is a digital archive of University of Strathclyde's Open Access research outputs. Strathprints provides access to thousands of Open Access research papers by University of Strathclyde researchers, including by researchers from the Department of Computer & Information Sciences involved in mathematically structured programming, similarity and metric search, computer security, software systems, combinatronics and digital health.

The Department also includes the iSchool Research Group, which performs leading research into socio-technical phenomena and topics such as information retrieval and information seeking behaviour.

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Clinical improvements with electromagnetic navigation versus conventional total knee arthroplasty

Blyth, Mark and Jones, Bryn and Smith, Julie and Rowe, Philip (2012) Clinical improvements with electromagnetic navigation versus conventional total knee arthroplasty. Journal of Bone and Joint Surgery - British Volume, 94-B (SUPP X). p. 44. ISSN 0301-620X

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Abstract

Recent advancements in optical navigated TKA have shown improved overall limb alignment, implant placement and reduced outliers compared to conventional TKA. This study represents the first RCT comparing EM navigation and conventional TKA. 3D alignment was analysed from CT scans. Clinical scores (Oxford Knee Score (OKS) and American Knee Society Score (AKSS)) were recorded at pre-op, 3 and 12 months post-op. Data presented includes 180 patients (n=90 per group) at 3 months and 140 (n=70 per group) at 12 months. The groups had similar mean mechanical axis alignments (EM 0.31° valgus; conventional 0.15° valgus). Mechanical axis alignment however was improved in the EM group with 92% within +/−3° of neutral compared to 84% of the conventional group (p=0.90). The EM group showed improved coronal and sagittal femoral alignment and improved coronal, sagittal and rotational tibial alignment, which was significant for sagittal femoral alignment (p=0.04). The OKS and AKSS scores were significantly better for the EM group at 3 months post-op (OKS p=0.02, AKSS p=0.04), but there was no difference between groups at 12 months. The mean pre-op range of motion (ROM) for both groups was 105°. This decreased at 3 months to 102° in the EM group and 99° in the conventional group, but there was a significant improvement by 12 months: EM=113° (p=0.012) and conventional=112° (p=0.026). ROM was statistically similar between groups at all assessment phases. Knee alignment was better restored following EM navigated TKA relative to conventional TKA, but the difference was not significant. The EM group showed greater clinical improvements at early follow-up; however this difference was not sustained at 12 months. ROM was seen to decrease at 3 months but then significantly improve by 12 month post-op. Proving cost-effectiveness for navigation systems in TKA remains a challenge.