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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2011

Open Access 01-12-2011 | Research article

Navigation of total knee arthroplasty: rotation of components and clinical results in a prospectively randomized study

Authors: Jan Schmitt, Carsten Hauk, Heino Kienapfel, Michael Pfeiffer, Turgay Efe, Susanne Fuchs-Winkelmann, Thomas J Heyse

Published in: BMC Musculoskeletal Disorders | Issue 1/2011

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Abstract

Background

Navigation was introduced into total knee arthroplasty (TKA) to improve accuracy of component position, function and survival of implants. This study was designed to assess the outcome of navigated TKA in comparison with conventional implantation with the focus on rotational component position and clinical mid-term results.

Methods

In a prospectively randomized single-blinded approach, 90 patients with primary gonarthrosis were assigned to three different groups. Thirty patients each were assigned to NexGen LPS without and with navigation (groups 1 and 2), and 30 patients to navigation with the Stryker Scorpio PS (group 3). The navigation system used was the imageless Stryker KneeTrac, version 1.0. Clinical outcome was assessed by a blinded observer applying the Knee Society Score (KSS) and a visual analogue scale (VAS) for pain. CT scans and radiographs were conducted prior to and 12 weeks after index surgery.

Results

Seventy-nine patients were available for clinical evaluation at 3 ± 0.4 years follow-up. Four implants had to be revised for early loosening or infection (4.4%). Four patients had died and three patients were not able to follow the invitation for clinical assessment. Functional results in the KSS were significantly lower after navigated TKA. Operation time and incisions with navigation were significantly longer. Significantly less radiological outliers with navigation were found for coronal alignment of the femur, only.

Conclusion

In this series, no beneficial effect for navigation in TKA could be shown assessing clinical data, as functional results in the presented series seemed to be lower after first generation navigated TKA. The clinical mid- to long-term value of navigation remains to be evaluated in larger patient series or meta-analyses at longer follow-up.

Trial registration number

DRKS 00000430
Appendix
Available only for authorised users
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Metadata
Title
Navigation of total knee arthroplasty: rotation of components and clinical results in a prospectively randomized study
Authors
Jan Schmitt
Carsten Hauk
Heino Kienapfel
Michael Pfeiffer
Turgay Efe
Susanne Fuchs-Winkelmann
Thomas J Heyse
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2011
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-12-16

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