No advantage with navigated versus conventional mechanically aligned total knee arthroplasty-10 year results of a randomised controlled trial
Farhan-Alanie, Omer M. and Altell, Tareq and O'Donnell, Sinead and May, Pauline and Doonan, James and Rowe, Philip and Jones, Bryn and Blyth, Mark J. G. (2022) No advantage with navigated versus conventional mechanically aligned total knee arthroplasty-10 year results of a randomised controlled trial. Knee Surgery, Sports Traumatology, Arthroscopy, 31 (3). pp. 751-759. ISSN 1433-7347 (https://doi.org/10.1007/s00167-022-07158-1)
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Abstract
Purpose: Computer-assisted surgery (CAS) total knee arthroplasty (TKA) remains a controversial area of surgical practice. The aim of this study is to report the ten-year revision rates and patient-reported outcome measures (PROMS) of a single-blinded, prospective, randomised controlled trial comparing electromagnetically (EM) navigated and conventional TKA. Methods: 199 patients were randomised to receive either EM navigated or conventional TKA where the aim of implantation was neutral mechanical alignment in all cases. Ten-year revision rates were collated and compared between the two intervention groups. Longitudinal PROMS data was collected prospectively at various time points up to 10 years post-operatively. Results: Over the ten-year period, there were 23 deaths (22.8%) in the EM navigation cohort and 30 deaths (30.6%) in the conventional cohort. At 10 years post-operatively, there was no statistically significant difference in all cause revision between the EM navigation and conventional cohort (4.0 vs 6.1%, p = 0.429). When analysing causes of revision that might be influenced by utilising EM navigation, there was no statistically significant difference in revisions (3.0% EM navigated vs 4.1% conventional group, p = 0.591). Patients that received navigated TKAs had improved Oxford Knee Society, American Knee Society Score and range of motion at 3 months following surgery compared to conventional TKA (p = 0.002, p = 0.032, and p = 0.05, respectively). However, from 1 to 10 years post-operatively, both interventions had equivalent outcomes. Conclusion: There is no difference in revision rates or clinical outcomes comparing EM navigated versus conventional TKA at ten-year follow-up. The expected mortality rate makes it unlikely that a difference in revision rates will reach statistical significance in the future. In the setting of an experienced knee arthroplasty surgeon, it is difficult to justify the additional costs of CAS in TKA surgery. Level of evidence: I.
ORCID iDs
Farhan-Alanie, Omer M., Altell, Tareq, O'Donnell, Sinead, May, Pauline, Doonan, James ORCID: https://orcid.org/0000-0001-6933-4840, Rowe, Philip ORCID: https://orcid.org/0000-0002-4877-8466, Jones, Bryn and Blyth, Mark J. G.;-
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Item type: Article ID code: 82787 Dates: DateEvent27 September 2022Published27 September 2022Published Online3 September 2022Accepted9 June 2022SubmittedSubjects: Medicine > Surgery Department: Faculty of Science > Strathclyde Institute of Pharmacy and Biomedical Sciences
Strategic Research Themes > Health and Wellbeing
Faculty of Engineering > Biomedical EngineeringDepositing user: Pure Administrator Date deposited: 14 Oct 2022 13:43 Last modified: 31 Oct 2024 04:50 URI: https://strathprints.strath.ac.uk/id/eprint/82787