J Knee Surg 2018; 31(07): 649-653
DOI: 10.1055/s-0037-1606375
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

No Difference in Functional Outcomes after Total Knee Arthroplasty with or without Pinless Navigation

Meng Zhu
1   Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
,
Jerry Yongqiang Chen
1   Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
,
Hwei Chi Chong
2   Department of Physiotherapy, Singapore General Hospital, Singapore, Singapore
,
Hee Nee Pang
1   Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
,
Darren Keng Jin Tay
1   Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
,
Shi-Lu Chia
1   Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
,
Ngai Nung Lo
1   Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
,
Seng Jin Yeo
1   Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
› Author Affiliations
Further Information

Publication History

30 November 2016

04 August 2017

Publication Date:
08 September 2017 (online)

Abstract

This study aims to investigate the functional outcomes of pinless navigation (BrainLAB VectorVision Knee 2.5 navigation system; Munich, Germany) as an intraoperative alignment guide in total knee arthroplasty (TKA). A prospective, 24-month follow-up study of 100 patients who were scheduled and randomized into two groups, the pinless navigation and conventional surgery, was conducted. All TKAs were performed with the surgical aim of achieving neutral coronal alignment with the 180-degree mechanical axis. The outcomes measured in this study were Oxford Knee Score (OKS), Knee Society Score (KSS), Short Form-36 (SF-36), and range of motion (ROM). At 24-month postoperatively, four and two patients were lost to follow-up from the pinless navigation group and conventional group, respectively. There were no significant differences in absolute scores of the OKS, KSS, and ROM, as well as changes from preoperative baseline, between pinless navigation and conventional groups at both 6 and 24 months postoperatively. Pinless navigation results in comparable functional outcomes as conventional TKA at 6 and 24 months postoperatively.

 
  • References

  • 1 Brin YS, Nikolaou VS, Joseph L, Zukor DJ, Antoniou J. Imageless computer assisted versus conventional total knee replacement. A Bayesian meta-analysis of 23 comparative studies. Int Orthop 2011; 35 (03) 331-339
  • 2 Fu Y, Wang M, Liu Y, Fu Q. Alignment outcomes in navigated total knee arthroplasty: a meta-analysis. Knee Surg Sports Traumatol Arthrosc 2012; 20 (06) 1075-1082
  • 3 Hetaimish BM, Khan MM, Simunovic N, Al-Harbi HH, Bhandari M, Zalzal PK. Meta-analysis of navigation vs conventional total knee arthroplasty. J Arthroplasty 2012; 27 (06) 1177-1182
  • 4 Bauwens K, Matthes G, Wich M. , et al. Navigated total knee replacement. A meta-analysis. J Bone Joint Surg Am 2007; 89 (02) 261-269
  • 5 Beldame J, Boisrenoult P, Beaufils P. Pin track induced fractures around computer-assisted TKA. Orthop Traumatol Surg Res 2010; 96 (03) 249-255
  • 6 Hoke D, Jafari SM, Orozco F, Ong A. Tibial shaft stress fractures resulting from placement of navigation tracker pins. J Arthroplasty 2011; 26 (03) 504.e5-504.e8
  • 7 Owens Jr RF, Swank ML. Low incidence of postoperative complications due to pin placement in computer-navigated total knee arthroplasty. J Arthroplasty 2010; 25 (07) 1096-1098
  • 8 Berning ET, Fowler RM. Thermal damage and tracker-pin track infection in computer-navigated total knee arthroplasty. J Arthroplasty 2011; 26 (06) 977.e21-977.e24
  • 9 Baier C, Maderbacher G, Springorum HR. , et al. No difference in accuracy between pinless and conventional computer-assisted surgery in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2014; 22 (08) 1819-1826
  • 10 Chen JY, Chin PL, Li Z. , et al. Radiological outcomes of pinless navigation in total knee arthroplasty: a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc 2015; 23 (12) 3556-3562
  • 11 Chen JY, Chin PL, Tay DK, Chia SL, Lo NN, Yeo SJ. Less outliers in pinless navigation compared with conventional surgery in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2014; 22 (08) 1827-1832
  • 12 Keyes BJ, Markel DC, Meneghini RM. Evaluation of limb alignment, component positioning, and function in primary total knee arthroplasty using a pinless navigation technique compared with conventional methods. J Knee Surg 2013; 26 (02) 127-132
  • 13 Maderbacher G, Schaumburger J, Keshmiri A. , et al. Pinless navigation in total knee arthroplasty: navigation reduced by the maximum?. Int Orthop 2015; 39 (03) 455-460
  • 14 Murray DW, Fitzpatrick R, Rogers K. , et al. The use of the Oxford hip and knee scores. J Bone Joint Surg Br 2007; 89 (08) 1010-1014
  • 15 Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 1989; (248) 13-14
  • 16 Ware Jr JE, Kosinski M, Bayliss MS, McHorney CA, Rogers WH, Raczek A. Comparison of methods for the scoring and statistical analysis of SF-36 health profile and summary measures: summary of results from the Medical Outcomes Study. Med Care 1995; 33 (4, Suppl): AS264-AS279
  • 17 Ware JE. SF-36 Physical and Mental Health Summary Scales: A User's Manual. Boston, MA: Health Institute, New England Medical Center; 1994
  • 18 Zhu M, Chen JY, Chong HC. , et al. Outcomes following total knee arthroplasty with CT-based patient-specific instrumentation. Knee Surg Sports Traumatol Arthrosc 2017; 25 (08) 2567-2572
  • 19 Yeo NE, Chen JY, Yew A, Chia SL, Lo NN, Yeo SJ. Prospective randomised trial comparing unlinked, modular bicompartmental knee arthroplasty and total knee arthroplasty: a five years follow-up. Knee 2015; 22 (04) 321-327
  • 20 Chen JY, Lo NN, Chong HC. , et al. The influence of body mass index on functional outcome and quality of life after total knee arthroplasty. Bone Joint J 2016; 98-B (06) 780-785
  • 21 Chen JY, Loh B, Woo YL, Chia SL, Lo NN, Yeo SJ. Fixed Flexion Deformity After Unicompartmental Knee Arthroplasty: How Much Is Too Much. J Arthroplasty 2016; 31 (06) 1313-1316
  • 22 Clement ND, MacDonald D, Simpson AH. The minimal clinically important difference in the Oxford knee score and Short Form 12 score after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2014; 22 (08) 1933-1939
  • 23 Rebal BA, Babatunde OM, Lee JH, Geller JA, Patrick Jr DA, Macaulay W. Imageless computer navigation in total knee arthroplasty provides superior short term functional outcomes: a meta-analysis. J Arthroplasty 2014; 29 (05) 938-944
  • 24 Zamora LA, Humphreys KJ, Watt AM, Forel D, Cameron AL. Systematic review of computer-navigated total knee arthroplasty. ANZ J Surg 2013; 83 (1-2): 22-30
  • 25 Cheng T, Pan XY, Mao X, Zhang GY, Zhang XL. Little clinical advantage of computer-assisted navigation over conventional instrumentation in primary total knee arthroplasty at early follow-up. Knee 2012; 19 (04) 237-245
  • 26 Harvie P, Sloan K, Beaver RJ. Computer navigation vs conventional total knee arthroplasty: five-year functional results of a prospective randomized trial. J Arthroplasty 2012; 27 (05) 667-72.e1
  • 27 Hernández-Vaquero D, Suarez-Vazquez A, Iglesias-Fernandez S. Can computer assistance improve the clinical and functional scores in total knee arthroplasty?. Clin Orthop Relat Res 2011; 469 (12) 3436-3442
  • 28 Parratte S, Pagnano MW, Trousdale RT, Berry DJ. Effect of postoperative mechanical axis alignment on the fifteen-year survival of modern, cemented total knee replacements. J Bone Joint Surg Am 2010; 92 (12) 2143-2149
  • 29 Zhou Z, Yew KS, Arul E. , et al. Recovery in knee range of motion reaches a plateau by 12 months after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2015; 23 (06) 1729-1733