Computer-assisted surgery versus manual total knee arthroplasty: A case-controlled study

Background: Restoration of neutral alignmentof the leg is an important factor affectingthe long-term results of total kneearthroplasty. Despite the use of modern instrumentsin total knee arthroplasty, componentmalalignment remains a problem.Computer-assisted systems have been developedin order to improve alignment ofcomponents. Th e objective of this study wasto determine whether the computer-assistedtotal knee arthroplasty is superior to the conventional surgical method with regard to theprecision of implant positioning.Patients and methods: A total of 44 patientswere included in the study. Twenty-threepatients underwent surgery using a computer-assisted navigation system. Th e controlgroup included 21 patients, who were operatedon using the conventional technique.Th e groups were similar with regard to age,gender, diagnosis, body mass index, side ofthe operated limb, implants and preoperativevalue of IKSKS. Th e two methods werecompared for alignment of the leg and theorientation of components on post-operativelong-leg coronal and lateral fi lms.Results: Th e groups were not signifi cantlydiff erent with regard to the accuracy of component positioning as compared to thatachived by conventional total knee arthroplasty(p > 0,05). Postoperative range of motionof the knees and postoperative value ofIKSKS were similar in both groups. Th e operatingtime was longer in the computer-assistedtotal knee arthroplasty, by 30 minuteson average. Th e blood loss was greater in thecomputer-assisted total knee arthroplasty, byapproximately 70 mL on average.Conclusions: Computer-assisted total kneearthroplasty yields better correction of legalignment and orientation of the componentscompared with the conventional technique.However, these results were not statisticalysignifi cant. Potential benefi ts in thelong-term outcome and functional improvementrequire further investigation.