Computer navigation reduces overall revision rate after TKA

The overall rate of revision and the rate revision for loosening following total knee arthroplasty was reduced with the use of computer navigation, according to study results.

Researchers assessed the cumulative percent revision following all non-navigated and navigated primary total knee arthroplasties (TKAs) performed in Australia from January 2003 to December 2012 and examined the type of and reason for revision, as well as the effect of age, surgeon volume and use of cement for the prosthesis. The researchers used Kaplan-Meier estimates of survivorship to describe the time to first revision and hazard ratios from Cox proportional hazards models with adjustment for age and sex to compare revision rates.

Overall, results showed computer navigation was utilized in 44,573 primary TKAs, with computer navigation use increasing from 2.4% in 2003 to 22.8% in 2012.

Richard N. de Steiger

At 9 years, the researchers found a cumulative percent revision following non-navigated TKA of 5.2% vs. 4.6% for computer-navigated TKA. Among younger patients, a significant difference was found in the rate of revision following non-navigated TKA vs. the rate of revision following navigated TKA, with a cumulative percent revision of 7.8% at 9 years in patients younger than 65 years of age who had undergone non-navigated TKA vs. 6.3% among patients who had undergone navigated TKA, according to study results.

Results showed patients who had undergone TKA with use of computer navigation had a significant reduction in the rate of revision due to loosening/lysis, which, according to the researchers, was the most common reason for revision of TKA. – by Casey Tingle

Disclosures: de Steiger is the Deputy Director of the Australian Orthopaedic Association. Please see the full study for a list of all other authors’ relevant financial disclosures.

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Source:

de Steiger RN, et al. J Bone Joint Surg Am. 2015;doi:10.2106/JBJS.M.01496.