Trends of Utilization and 90-Day Complication Rates for Computer-Assisted Navigation and Robotic Assistance for Total Knee Arthroplasty in the United States From 2010 to 2018

Background. Since the introduction of robot-assisted navigation in primary total knee arthroplasty (TKA), there has been little research conducted examining the efficiency and accuracy of the system compared to computer-assisted navigation systems. Objective. To compare the efficiency and accuracy of Praxim robot-assisted navigation (RAN) and Stryker computer-assisted navigation (CAN) in primary TKA. Methods. This was a retrospective study consisting of 52 patients who underwent primary TKA utilizing RAN and 29 patients utilizing CAN. The primary outcome measure was navigation time. Secondary outcome measures included intraoperative final mechanical axis alignment, intraoperative robot-assisted bone cut accuracy, tourniquet time, and hospitalization length. Results. RAN navigation times were, on average, 9.0 minutes shorter compared to CAN after adjustment. The average absolute intraoperative malalignment was 0.5° less in the RAN procedures compared to the CAN procedures after adjustment. Patients in the RAN group tended to be discharged 0.6 days earlier compared to patients in the CAN group after adjustment. Conclusions. Among patients undergoing TKA, there was decreased navigation time, decreased final malalignment, and decreased hospitalization length associated with the use of RAN when compared to CAN independent of age, BMI, and pre-replacement alignment.

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Patient-specific instrumentation for total knee arthroplasty does not match the pre-operative plan as assessed by intra-operative computer-assisted navigation

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-013-2670-1 ◽

2013 ◽

Vol 22 (3) ◽

pp. 660-665 ◽

Cited By ~ 34

Author(s):

Corey Scholes ◽

Varun Sahni ◽

Sebastien Lustig ◽

David A. Parker ◽

Myles R. J. Coolican

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Patient Specific ◽

Computer Assisted ◽

Assisted Navigation ◽

Patient Specific Instrumentation ◽

Total Knee

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Accuracy of femoral rotational alignment in total knee arthroplasty using computer assisted navigation

Computer Aided Surgery ◽

10.1080/10929080802045640 ◽

2008 ◽

Vol 13 (3) ◽

pp. 167-172 ◽

Cited By ~ 1

Author(s):

Camilo Restrepo ◽

William Hozack ◽

Fabio Orozco ◽

Javad Parvizi

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Rotational Alignment ◽

Computer Assisted ◽

Assisted Navigation ◽

Total Knee

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Total Knee Arthroplasty with Use of Computer-Assisted Navigation Compared with Conventional Guiding Systems in the Same Patient: Radiographic Results in Asian Patients

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.j.00325 ◽

2011 ◽

Vol 93 (13) ◽

pp. 1197-1202 ◽

Cited By ~ 42

Author(s):

Tsan-Wen Huang ◽

Wei-Hsiu Hsu ◽

Kuo-Ti Peng ◽

Robert Wen-Wei Hsu ◽

Yi-Jan Weng ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Computer Assisted ◽

Assisted Navigation ◽

Asian Patients ◽

Total Knee

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Ligament balancing in computer-assisted total knee arthroplasty: Improved clinical results with a spring-loaded tensioning device

Proceedings of the Institution of Mechanical Engineers Part H Journal of Engineering in Medicine ◽

10.1243/09544119jeim269 ◽

2007 ◽

Vol 221 (7) ◽

pp. 755-761 ◽

Cited By ~ 13

Author(s):

M Swank ◽

J R Romanowski ◽

L L Korbee ◽

S Bignozzi

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Clinical Results ◽

Computer Assisted ◽

Knee Ligament ◽

Assisted Navigation ◽

Knee Mechanics ◽

Computer Assistance ◽

Significant Difference ◽

Total Knee

Total knee arthroplasty (TKA) remains one of the most successful procedures in orthopaedic surgery. Complications certainly exist and are often related to failure of knee ligament balance. This asymmetry subsequently leads to component mal-alignment and loosening often secondary to deviation of the lower extremity mechanical axis. Understanding knee mechanics is essential, and recent technological advances have begun to minimize postoperative problems. A tensioning device that respects the native patellofemoral anatomy as well as the natural ligamentous strains has been developed. The surgical integration of computer-assisted navigation has allowed for enhanced accuracy and subsequently better results. The purpose of the current paper is to discuss the evolution of an improved ligament tensioning device, in the setting of classic mechanical guidance versus computer assistance and its postoperative impact on total knee outcomes in terms of manipulation rates and two-year radiographic alignment data. Based on a single surgeon series, mechanically guided arthroplasties resulted in a 16 per cent manipulation rate. Computer assistance with spacer blocks decreased the manipulation rate to 14 per cent, while using a novel tensioner device further decreased the manipulation rate to 7 per cent, a significant difference of p <0.01. Radiographic data illustrate all TKAs with the tensioner to be within 4° of the desired position.

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