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Scientific Articles   |    
Computer-Navigated Versus Conventional Total Knee ArthroplastyA Prospective Randomized Trial
Young-Hoo Kim, MD1; Jang-Won Park, MD1; Jun-Shik Kim, MD1
1 The Joint Replacement Center at Ewha Womans University MokDong Hospital, 911-1, MokDong, YangChun-Ku, Seoul, Republic of Korea (158-710). E-mail address for Y.-H. Kim: younghookim@ewha.ac.kr
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Investigation performed at the Joint Replacement Center, Ewha Womans University School of Medicine, Seoul, Republic of Korea

This article was chosen to appear electronically on October 10, 2012, in advance of publication in a regularly scheduled issue.

A commentary by Thomas J. Blumenfeld, MD, is linked to the online version of this article at jbjs.org.



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2012 Nov 21;94(22):2017-2024. doi: 10.2106/JBJS.L.00142
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Abstract

Update 

This article was updated on December 27, 2012, because of a previous error. Table I previously listed a p value of 0.511 in row 1 of the table (number of patients [knees]) and a p value of 0.125 in row 7 of the table (diagnosis of osteoarthritis). Those p values were inserted in error and have been removed.

Background: 

The literature lacks studies that confirm whether the improved radiographic alignment that can be achieved with computer-navigated total knee arthroplasty improves patients’ activities of daily living or the durability of total knee prostheses. The purpose of this study was to determine whether computer-navigated total knee arthroplasty improves the clinical function, alignment, and survivorship of the components.

Methods: 

We prospectively compared the results of 520 patients with osteoarthritis who underwent computer-navigated total knee arthroplasty for one knee and conventional total knee arthroplasty for the other. The assignment of the knee to navigation or not was done randomly. There were 452 women (904 knees) and sixty-eight men (136 knees) with a mean age of sixty-eight years (range, forty-nine to eighty-eight years) at the time of the index arthroplasty. The mean follow-up period was 10.8 years (range, ten to twelve years). The patients were assessed clinically and radiographically with the rating system of the Knee Society and with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score at three months, one year, and annually thereafter.

Results: 

Total knee scores, knee function scores, pain scores, WOMAC scores, knee motion, and activity scores did not show statistically significant differences between the two groups preoperatively or at the time of the final follow-up. Alignment and the survivorship of the components were not significantly different between the two groups. The Kaplan-Meier survivorship with revision as the end point at 10.8 years was 98.8% (95% confidence interval [CI], 0.96 to 1.00) in the computer-navigated total knee arthroplasty group and 99.2% (95% CI, 0.96 to 1.00) in the conventional total knee arthroplasty group.

Conclusions: 

Our data demonstrated no difference in clinical function or alignment and survivorship of the components between the knees that underwent computer-navigated total knee arthroplasty and those that underwent conventional total knee arthroplasty.

Level of Evidence: 

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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