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No differences in outcome scores seen between navigated, conventional TKR groups

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DUBLIN — The functional outcome scores between computer-navigated and conventional total knee replacement may be no different 5 years after surgery despite the better alignment achieved using navigation, according a presenter here.

“The results essentially showed that there was no statistically significant difference in terms of functional outcome and patient satisfaction was similar,” George McKay, said at the British Orthopaedic Association and the Irish Orthopaedic Association Combined Meeting 2011.

In the study, McKay and his team prospectively randomized 35 patients to undergo Duracon (Stryker Orthopaedics, St. Leonards, Australia) total knee replacement (TKR) without patellar resurfacing using computer navigation (Stryker Image Free Computer Navigation System version 1.0; Stryker Orthopaedics) and 36 patients to undergo TKR using a jig-based method. The groups were matched for age, gender, height, weight, body mass index, American Society of Anesthesiologists grade and preoperative deformity. All operations were performed by a single surgeon. Reviews were undertaken by senior physical therapist who was blinded to the patients’ status using the validated functional outcome measures, which included the Knee Society Score, WOMAC scores and SF-36 scores. All patients underwent CT scanning of the implanted prosthesis.

Five years postoperatively, 24 patients in the navigated group and 22 patients in the conventional group were available for review. No statistically significant difference was seen in any of the outcome scores when comparing navigated and conventional groups. No statistically significant difference was seen between 2- and 5-year results for either group.

McKay said that due to the low numbers in each group, the data were compared with retrospective cohorts of 100 navigated and 70 conventional TKRs performed with this study during the same 5-year period. Within the retrospective cohorts, no statistically significant differences were found when comparing outcome scores. The team did not identify any statistically significant differences when comparing parallel scores between the prospective and retrospective cohorts.

Reference:

• McKay G, Harvie P, Sloan K, Beaver R. Computer navigation versus conventional total knee replacement: a prospective, randomised control trial showing no difference in functional results at five years. Paper #80. Presented at the British Orthopaedic Association and the Irish Orthopaedic Association Combined Meeting 2011. Sept. 13-16. Dublin.

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