2024, Number 5
<< Back Next >>
Acta Ortop Mex 2024; 38 (5)
Computer-assisted navigation in total knee arthroplasty. A narrative review of the literature
Hernández-Vaquero D
Language: Spanish
References: 53
Page: 321-332
PDF size: 267.21 Kb.
ABSTRACT
Navigation in total knee arthroplasties has been recommended in recent years to facilitate the technique and improve its results. An extensive literature has compared it with conventional surgery, but its superiority has not been able to be demonstrated. Given the abundant bibliography and disparity in their conclusions, a good number of meta-analyses have been published that have attempted to summarize and schematize the results. We have reviewed 41 published meta-analyses comparing both techniques. Most of them have focused on the placement of implants and the restoration of the axes of the extremity, demonstrating the superiority of navigation. On the contrary, no clinically valuable differences have been observed when analyzing the clinical and functional results. However, navigation allows a dynamic view of the knee, an objective evaluation of the soft tissues and ligaments, and is essential for functional alignment as an individualized technique.
REFERENCES
Delp SL, Stulberg SD, Davies B, Picard F, Leitner F. Computer assisted knee replacement. Clin Orthop Relat Res. 1998; 354: 49-56. Available in: https://doi.org/10.1097/00003086-199809000-00007
Bendich I, Kapadia M, Alpaugh K, Diane A, Vigdorchik J, Westrich G. 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. Arthroplasty Today. 2021; 11: 134-9.
Matar HE, Platt SR, Gollish JD, Cameron HU. Overview of randomized controlled trials in total knee arthroplasty (47,675 patients): what have we learnt? J Arthroplasty. 2020; 35: 1729-36. Available in: https://doi.org/10.1016/j.arth.2020.01.065
Mason JB, Fehring TK, Estok R, Banel D, Fahrbach K. Meta-analysis of alignment outcomes in computer-assisted total knee arthroplasty surgery. J Arthroplasty. 2007; 22: 1097-106. Available in: https://doi.org/10.1016/j.arth.2007.08.001
Novicoff WM, Saleh KJ, Mihalko WM, Wang XQ, Knaebel HP. Primary total knee arthroplasty: a comparison of computer-assisted and manual techniques. Instr Course Lect. 2010; 59: 109-17.
Cheng T, Zhang G, Zhang X. Imageless navigation system does not improve component rotational alignment in total knee arthroplasty. J Surg Res. 2011; 171: 590-600. Available in: https://doi.org/10.1016/j.jss.2010.05.006
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: 1177-82. Available in: https://doi.org/10.1016/j.arth.2011.12.028
Cheng T, Zhao S, Peng X, Zhang X. Does computer-assisted surgery improve postoperative leg alignment and implant positioning following total knee arthroplasty? A meta-analysis of randomized controlled trials? Knee Surg Sports Traumatol Arthrosc. 2012; 20: 1307-22. Available in: https://doi.org/10.1007/s00167-011-1588-8
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: 1075-82. Available in: https://doi.org/10.1007/s00167-011-1695-6
Kuzyk PR, Higgins GA, Tunggal JA, Sellan ME, Waddell JP, Schemitsch EH. Computer navigation vs extramedullary guide for sagittal alignment of tibial components: radiographic study and meta-analysis. J Arthroplasty. 2012; 27: 630-7. Available in: https://doi.org/10.1016/j.arth.2011.07.001
Thienpont E, Fennema P, Price A. Can technology improve alignment during knee arthroplasty. Knee. 2013; 20 Suppl 1: S21-8. Available in: https://doi.org/10.1016/S0968-0160(13)70005-X
Meijer MF, Reininga IH, Boerboom AL, Bulstra SK, Stevens M. Does imageless computer-assisted TKA lead to improved rotational alignment or fewer outliers? A systematic review. Clin Orthop Relat Res. 2014; 472: 3124-33. Available in: https://doi.org/10.1007/s11999-014-3688-5
Wang Zeng-Lian, Zhao Li, Zhao Jia-Guo. Meta-analysis of limb and prosthesis alignment restoration after navigated total knee arthroplasty versus conventional total knee arthroplasty. Chinese J Tissue Eng Res. 2014; 18: 5707-14.
Tandogan RN, Kort NP, Ercin E, van Rooij F, Nover L, Saffarini M, et al. Computer-assisted surgery and patient-specific instrumentation improve the accuracy of tibial baseplate rotation in total knee arthroplasty compared to conventional instrumentation: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2022; 30: 2654-65. Available in: https://do.org/10.1007/s00167-021-06495-x
Bathis H, Shafizadeh S, Paffrath T, Simanski C, Grifka J, Lüring C. Sind navigierte Knieendoprothesen tatsachlich praziser implantiert? Eine metaanalyse vergleichender studien [Are computer assisted total knee replacements more accurately placed? A meta-analysis of comparative studies] Orthopade. 2006; 35: 1056-65. Available in: https://doi.org/10.1007/s00132-006-1001-3
Bauwens K, Matthes G, Wich M, Gebhard F, Hanson B, Ekkernkamp A, Stengel D. Navigated total knee replacement. A meta-analysis. J Bone Joint Surg Am. 2007; 89: 261-9. Available in: https://doi.org/10.2106/JBJS.F.00601
Li B, Waresijiang N, Zhao X-B, Yuan H, Comparison of computer navigation and traditional method for total knee arthroplasty implant placement: a systematic review. Chinese J Evid Based Med. 2010; 10: 1259-68.
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: 331-9. Available in: https://doi.org/10.1007/s00264-010-1008-6
Burnett RS, Barrack RL. Computer-assisted total knee arthroplasty is currently of no proven clinical benefit: a systematic review. Clin Orthop Relat Res. 2013; 471: 264-76. Available in: https://doi.org/10.1007/s11999-012-2528-8
Zamora LA, Humphreys KJ, Watt AM, Forel D, Cameron AL. Systematic review of computer-navigated total knee arthroplasty. ANZ J Surg. 2013; 83: 22-30. Available in: https://doi.org/10.1111/j.1445-2197.2012.06255.x
Liu BG, Pang QJ. Meta-analysis of therapeutic effects of computer-assisted navigation versus conventional total knee arthroplasty. Zhongguo Zuzhi Gongcheng Yanjiu (Chinese Journal of Tissue Engineering Research). 2014; 53: 6542-7. Available in: https://doi.org/10.3969/j.issn.2095-4344
Moskal JT, Capps SG, Mann JW, Scanelli JA. Navigated versus conventional total knee arthroplasty. J Knee Surg. 2014; 27: 235-48. Available in: https://doi.org/10.1055/s-0033-1360659
Rebal BA, Babatunde OM, Lee JH, Geller JA, Patrick DA Jr, Macaulay W. Imageless computer navigation in total knee arthroplasty provides superior short term functional outcomes: a meta-analysis. J Arthroplasty. 2014; 29: 938-44. Available in: https://doi.org/10.1016/j.arth.2013.09.018
Shi J, Wei Y, Wang S, Chen F, Wu J, Huang G, et al, Computer navigation and total knee arthroplasty. Orthopedics. 2014; 37: e39-43. Available in: https://doi.org/10.3928/01477447-20131219-15
Alcelik IA, Blomfield MI, Diana G, Gibbon AJ, Carrington N, Burr S. A Comparison of short-term outcomes of minimally invasive computer-assisted vs minimally invasive conventional instrumentation for primary total knee arthroplasty: a systematic review and meta-analysis. J Arthroplasty. 2016; 31: 410-8. Available in: https://doi.org/10.1016/j.arth.2015.09.013
Han SB, Kim HJ, Kim TK, In Y, Oh KJ, Koh IJ, et al. Computer navigation is effective in reducing blood loss but has no effect on transfusion requirement following primary total knee arthroplasty: a meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2016; 24: 3474-81. Available in: https://doi.org/10.1007/s00167-016-4053-x
Shin YS, Kim HJ, Ko YR, Yoon JR. Minimally invasive navigation-assisted versus conventional total knee arthroplasty: a meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2016; 24: 3425-32. Available in: https://doi.org/10.1007/s00167-016-4016-2
Rhee SJ, Kim HJ, Lee CR, Kim CW, Gwak HC, Kim JH. A comparison of long-term outcomes of computer-navigated and conventional total knee arthroplasty: a meta-analysis of randomized controlled trials. J Bone Joint Surg Am. 2019; 101: 1875-85. Available in: https://doi.org/10.2106/JBJS.19.00257
Bouché PA, Corsia S, Dechartres A, Resche-Rigon M, Nizard R. Are there differences in accuracy or outcomes scores among navigated, robotic, patient-specific instruments or standard cutting guides in TKA? A network meta-analysis. Clin Orthop Relat Res. 2020; 478: 2105-16. Available in: https://doi.org/10.1097/CORR.0000000000001324
Gao J, Dong S, Li JJ, Ge L, Xing D, Lin J. New technology-based assistive techniques in total knee arthroplasty: a Bayesian network meta-analysis and systematic review. Int J Med Robot. 2020; 27: e2189. Available in: https://doi.org/10.1002/rcs.2189
Lee DY, Park YJ, Hwang SC, Park JS, Kang DG. No differences in mid- to long-term outcomes of computer-assisted navigation versus conventional total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2020; 28: 3183-92. Available in: https://doi.org/10.1007/s00167-019-05808-5
Zhao L, Xu F, Lao S, Zhao J, Wei Q. Comparison of the clinical effects of computer-assisted and traditional techniques in bilateral total knee arthroplasty: a meta-analysis of randomized controlled trials. PLoS One. 2020; 15: e0239341. Available in: https://doi.org/10.1371/journal.pone.0239341
Madanipour S, Singh P, Karia M, Bhamra JS, Abdul-Jabar HB. Trainee performed total knee arthroplasty is safe and effective: a systematic review and meta-analysis comparing outcomes between trainees and consultants. Knee. 2021; 30: 291-304. Available in: https://doi.org/10.1016/j.knee.2021.04.013
Lei K, Liu L, Chen X, Feng Q, Yang L, Guo L. Navigation and robotics improved alignment compared with PSI and conventional instrument, while clinical outcomes were similar in TKA: a network meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2022; 30: 721-33. Available in: https://doi.org/10.1007/s00167-021-06436-8
Luan Y, Wang H, Zhang M, Li J, Zhang N, Liu B, et al. Comparison of navigation systems for total knee arthroplasty: a systematic review and meta-analysis. Front Surg. 2023; 10: 1112147. Available in: https://doi.org/10.3389/fsurg.2023.1112147
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: 237-45. Available in: https://doi.org/10.1016/j.knee.2011.10.001
Xie C, Liu K, Xiao L, Tang R. Clinical outcomes after computer-assisted versus conventional total knee arthroplasty. Orthopedics. 2012; 35: e647-53. Available in: https://doi.org/10.3928/01477447-20120426-17
Van der List JP, Chawla H, Joskowicz L, Pearle AD. Current state of computer navigation and robotics in unicompartmental and total knee arthroplasty: a systematic review with meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2016; 24: 3482-95. Available in: https://doi.org/10.1007/s00167-016-4305-9
Panjwani TR, Mullaji A, Doshi K, Thakur H. Comparison of functional outcomes of computer-assisted vs conventional total knee arthroplasty: a systematic review and meta-analysis of high-quality, prospective studies. J Arthroplasty. 2019; 34: 586-93. Available in: https://doi.org/:10.1016/j.arth.2018.11.028
Ayekoloye C, Nwangwu O, Alonge T. Computer navigation-assisted knee replacement demonstrates improved outcome compared with conventional knee replacement at mid-term follow-up: a systematic review and meta-analysis. Indian J Orthop. 2020; 13(54): 757-66. Available in: https://doi.org/10.1007/s43465-020-00161-z
Chin BZ, Seck VMH, Syn NL, Wee IJY, Tan SSH, O'Neill GK. Computer-navigated versus conventional total knee arthroplasty: a meta-analysis of functional outcomes from level I and II randomized controlled trials. J Knee Surg. 2021; 34: 648-58. Available in: https://doi.org/10.1055/s-0039-1700494
Plaskos C, Blum C, Lynch B, Ackerman M, Islam S, Lepkowsky E, Koenig J. Conventional vs. robotic/computer assisted total knee arthroplasty: a meta-analysis. J Orthopaedic Experience & Innovation. 2021.
Kim AG, Bernhard Z, Acuña AJ, Wu VS, Kamath AF. Use of intraoperative technology in total knee arthroplasty is not associated with reductions in postoperative pain. Knee Surg Sports Traumatol Arthrosc. 2023; 31: 1370-81. Available in: https://doi.org/10.1007/s00167-022-07098-w
Bathis H, Kappel P, Pfeiffer TR, Frohlich M, Caspers M, Ates DM. Gibt es noch Gründe für die Navigation in der Knieendoprothetik? [Future implications of navigation in total knee arthroplasty]. Orthopadie (Heidelb). 2022; 51: 708-18. German. Available in: https://doi.org/:10.1007/s00132-022-04285-y
Hernández-Vaquero D. La alineación de las artroplastías de rodilla. Antiguos mitos y nuevas controversias. Rev Esp Cir Ortop Traumatol. 2021; 65: 386-97. Available in: https://doi.org/10.1016/j.recot.2021.01.002
Cohen JS, Agarwal AR, Gu A, et al. No difference in 30-day mortality between patients undergoing bilateral simultaneous total knee arthroplasty with technology assistance compared to conventional instrumentation. HSS Journal. 2023; Epub 2023 April 18. Available in: https://doi.org/10.1177/15563316231160155
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: 3436-42. Available in: https://doi.org/10.1007/s11999-011-2044-2
Bhandari M, Guyatt GH, Montori V, Devereaux PJ, Swiontkowski MF. User's guide to the orthopaedic literature: how to use a systematic literature review. J Bone Joint Surg Am. 2002; 84: 1672-82.
Constantinescu DS, Costello JP, Yakkanti RR, Vanden Berge DJ, Carvajal Alba JA, Hernandez VH, D'Apuzzo MR. Lower peri-operative complication rates and shorter lengths of hospital stay associated with technology assisted total knee arthroplasty versus conventional instrumentation in primary total knee arthroplasty. J Arthroplasty. 2024; 39(6): 1512-17. Available in: https://doi.org/10.1016/j.arth.2023.12.015
LaValva SM, Chiu Y-F, Fowler MJ, Lyman S, Carli AV. Does computer navigation or robotic assistance affect the risk of periprosthetic joint infection in primary total knee arthroplasty? A propensity score-matched cohort analysis. J Arthroplasty. 2024; 39: 96-102. Available in: https://doi.org/10.1016/j.arth.2023.08.007
Smith TJ, Siddiqi A, Forte SA, Judice A, Sculco PK, Vigdorchik JM, Schwarzkopf R, Springer BD. Periprosthetic fractures through tracking pin sites following computer navigated and robotic total and unicompartmental knee arthroplasty: a systematic review. JBJS Rev. 2021; 9: e20.00091. Available in: https://doi.org/10.2106/JBJS.RVW.20.00091
Heinz T, Eidmann A, Anderson P, Weibenberger M, Jakuscheit A, Rudert M, Stratos I. Trends in computer-assisted surgery for total knee arthroplasty in Germany: an analysis based on the operative procedure classification system between 2010 to 2021. J Clin Med. 2023; 12: 549. Available in: https://doi.org/10.3390/jcm12020549
Shi JL, Mojica ES, Moverman MA, Pagani NR, Puzzitiello RN, Menendez ME, et al. The reverse fragility index: interpreting the current literature on long-term survivorship of computer-navigated versus conventional TKA: a systematic review and cross-sectional study of randomized controlled trials. J Bone Joint Surg Am. 2023; 105: 157-63. Available in: https://doi.org/10.2106/JBJS.22.00311