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Erschienen in: International Orthopaedics 3/2012

01.03.2012 | Original Paper

A five to seven year follow-up comparing computer-assisted vs freehand TKR with regard to clinical parameters

verfasst von: C. Lüring, M. Kauper, H. Bäthis, L. Perlick, J. Beckmann, J. Grifka, M. Tingart, B. Rath

Erschienen in: International Orthopaedics | Ausgabe 3/2012

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Abstract

Purpose

Computer-assisted knee surgery has become established in routine clinical practice. Still, there is no study investigating midterm clinical outcome after five to seven years postoperatively. We aimed to test the hypothesis that there is no difference either for subjective [Western Ontario and McMaster Universities (WOMAC) scores] or for objective (Knee Society Score, degree of flexion) criteria between computer-assisted total knee replacement (TKR) and freehand TKR after 5.6–7.3 years.

Methods

We performed a matched-pair analysis; 100 patients who received a primary TKR were investigated after a median follow-up of 6.25 years. Group A was operated on with the support of a computer system, while surgery on patients in group B was performed with the freehand technique. We determined WOMAC Score, Knee Society Score and degree of flexion.

Results

Overall we found similar results for WOMAC Score [group A: 42.98 (SD 13.80); group B: 41.54 (SD 15.01; p = 0.62)], Knee Society Score [group A: 168.20 (SD 21.94); group B: 166.60 (SD 21.44; p = 0.71)] and range of motion [group A: 106° (SD 9.19); group B 107° (SD 7.44; p = 0.62)].

Conclusions

No significant differences in midterm clinical outcome were found after TKR performed in the freehand vs computer-assisted technique.
Literatur
1.
Zurück zum Zitat Glant TT, Jacobs JJ (1994) Response of three murine macrophage populations to particulate debris: bone resorption in organ cultures. J Orthop Res 12:720–731PubMedCrossRef Glant TT, Jacobs JJ (1994) Response of three murine macrophage populations to particulate debris: bone resorption in organ cultures. J Orthop Res 12:720–731PubMedCrossRef
2.
Zurück zum Zitat Rodriguez JA, Bhende H, Ranawat CS (2001) Total condylar knee replacement: a 20-year followup study. Clin Orthop Relat Res 388:10–17PubMedCrossRef Rodriguez JA, Bhende H, Ranawat CS (2001) Total condylar knee replacement: a 20-year followup study. Clin Orthop Relat Res 388:10–17PubMedCrossRef
3.
Zurück zum Zitat Sharkey PF, Hozack WJ, Rothman RH, Shastri S, Jacoby SM (2002) Insall Award paper. Why are total knee arthroplasties failing today? Clin Orthop Relat Res 404:7–13PubMedCrossRef Sharkey PF, Hozack WJ, Rothman RH, Shastri S, Jacoby SM (2002) Insall Award paper. Why are total knee arthroplasties failing today? Clin Orthop Relat Res 404:7–13PubMedCrossRef
4.
Zurück zum Zitat Chen FS, Scher DM, Clancy RM, Vera-Yu A, Di Cesare PE (1999) In vitro and in vivo activation of polymorphonuclear leukocytes in response to particulate debris. J Biomed Mater Res 48:904–912PubMedCrossRef Chen FS, Scher DM, Clancy RM, Vera-Yu A, Di Cesare PE (1999) In vitro and in vivo activation of polymorphonuclear leukocytes in response to particulate debris. J Biomed Mater Res 48:904–912PubMedCrossRef
5.
Zurück zum Zitat Font-Rodriguez DE, Scuderi GR, Insall JN (1997) Survivorship of cemented total knee arthroplasty. Clin Orthop Relat Res 345:79–86PubMedCrossRef Font-Rodriguez DE, Scuderi GR, Insall JN (1997) Survivorship of cemented total knee arthroplasty. Clin Orthop Relat Res 345:79–86PubMedCrossRef
6.
Zurück zum Zitat Jacobs JJ, Gilbert JL, Urban RM (1998) Corrosion of metal orthopaedic implants. J Bone Joint Surg Am 80:268–282PubMed Jacobs JJ, Gilbert JL, Urban RM (1998) Corrosion of metal orthopaedic implants. J Bone Joint Surg Am 80:268–282PubMed
7.
Zurück zum Zitat Kubo T, Sawada K, Hirakawa K, Shimizu C, Takamatsu T, Hirasawa Y (1999) Histiocyte reaction in rabbit femurs to UHMWPE, metal, and ceramic particles in different sizes. J Biomed Mater Res 45:363–369PubMedCrossRef Kubo T, Sawada K, Hirakawa K, Shimizu C, Takamatsu T, Hirasawa Y (1999) Histiocyte reaction in rabbit femurs to UHMWPE, metal, and ceramic particles in different sizes. J Biomed Mater Res 45:363–369PubMedCrossRef
8.
Zurück zum Zitat Woolson ST, Northrop GD (2004) Mobile- vs. fixed-bearing total knee arthroplasty: a clinical and radiologic study. J Arthroplasty 19:135–140PubMedCrossRef Woolson ST, Northrop GD (2004) Mobile- vs. fixed-bearing total knee arthroplasty: a clinical and radiologic study. J Arthroplasty 19:135–140PubMedCrossRef
9.
Zurück zum Zitat Petersen TL, Engh GA (1988) Radiographic assessment of knee alignment after total knee arthroplasty. J Arthroplasty 3:67–72PubMedCrossRef Petersen TL, Engh GA (1988) Radiographic assessment of knee alignment after total knee arthroplasty. J Arthroplasty 3:67–72PubMedCrossRef
10.
Zurück zum Zitat Mahaluxmivala J, Bankes MJ, Nicolai P, Aldam CJH, Allen PW (2001) The effect of surgeon experience on component positioning in 673 press fit condylar posterior cruciate-sacrificing total knee arthroplasties. J Arthroplasty 16:635–640PubMedCrossRef Mahaluxmivala J, Bankes MJ, Nicolai P, Aldam CJH, Allen PW (2001) The effect of surgeon experience on component positioning in 673 press fit condylar posterior cruciate-sacrificing total knee arthroplasties. J Arthroplasty 16:635–640PubMedCrossRef
11.
Zurück zum Zitat Delp SL, Stulberg SD, Davies B, Picard F, Leitner F (1998) Computer assisted knee replacement. Clin Orthop Relat Res 354:49–56PubMedCrossRef Delp SL, Stulberg SD, Davies B, Picard F, Leitner F (1998) Computer assisted knee replacement. Clin Orthop Relat Res 354:49–56PubMedCrossRef
12.
Zurück zum Zitat Laskin RS (2003) Instrumentation pitfalls: you just can’t go on autopilot! J Arthroplasty 18:18–22PubMedCrossRef Laskin RS (2003) Instrumentation pitfalls: you just can’t go on autopilot! J Arthroplasty 18:18–22PubMedCrossRef
13.
Zurück zum Zitat Novotny J, Gonzalez MH, Amirouche FM, Li YC (2001) Geometric analysis of potential error in using femoral intramedullary guides in total knee arthroplasty. J Arthroplasty 16:641–647PubMedCrossRef Novotny J, Gonzalez MH, Amirouche FM, Li YC (2001) Geometric analysis of potential error in using femoral intramedullary guides in total knee arthroplasty. J Arthroplasty 16:641–647PubMedCrossRef
14.
Zurück zum Zitat Reed SC, Gollish J (1997) The accuracy of femoral intramedullary guides in total knee arthroplasty. J Arthroplasty 12:677–682PubMedCrossRef Reed SC, Gollish J (1997) The accuracy of femoral intramedullary guides in total knee arthroplasty. J Arthroplasty 12:677–682PubMedCrossRef
15.
Zurück zum Zitat Bäthis H, Perlick L, Tingart M, Lüring C, Zurakowski D, Grifka J (2004) Alignment in total knee arthroplasty. A comparison of computer-assisted surgery with the conventional technique. J Bone Joint Surg Br 86(5):682–687PubMedCrossRef Bäthis H, Perlick L, Tingart M, Lüring C, Zurakowski D, Grifka J (2004) Alignment in total knee arthroplasty. A comparison of computer-assisted surgery with the conventional technique. J Bone Joint Surg Br 86(5):682–687PubMedCrossRef
16.
Zurück zum Zitat Bauwens K, Matthes G, Wich M, Gebhard F, Hanson B, Ekkernkamp A, Stengel D (2007) Navigated total knee replacement. A meta-analysis. J Bone Joint Surg Am 89(2):261–269PubMedCrossRef Bauwens K, Matthes G, Wich M, Gebhard F, Hanson B, Ekkernkamp A, Stengel D (2007) Navigated total knee replacement. A meta-analysis. J Bone Joint Surg Am 89(2):261–269PubMedCrossRef
17.
Zurück zum Zitat Bolognesi M, Hofmann A (2005) Computer navigation versus standard instrumentation for TKA: a single-surgeon experience. Clin Orthop Relat Res 440:162–169PubMedCrossRef Bolognesi M, Hofmann A (2005) Computer navigation versus standard instrumentation for TKA: a single-surgeon experience. Clin Orthop Relat Res 440:162–169PubMedCrossRef
18.
Zurück zum Zitat Jenny JY, Clemens U, Kohler S, Kiefer H, Konermann W, Miehlke RK (2005) Consistency of implantation of a total knee arthroplasty with a non-image-based navigation system: a case-control study of 235 cases compared with 235 conventionally implanted prostheses. J Arthroplasty 20:832–889PubMedCrossRef Jenny JY, Clemens U, Kohler S, Kiefer H, Konermann W, Miehlke RK (2005) Consistency of implantation of a total knee arthroplasty with a non-image-based navigation system: a case-control study of 235 cases compared with 235 conventionally implanted prostheses. J Arthroplasty 20:832–889PubMedCrossRef
19.
Zurück zum Zitat Kamat YD, Aurakzai KM, Adhikari AR, Matthews D, Kalairajah Y, Field RE (2009) Does computer navigation in total knee arthroplasty improve patient outcome at midterm follow-up? Int Orthop 33(6):1567–1570PubMedCrossRef Kamat YD, Aurakzai KM, Adhikari AR, Matthews D, Kalairajah Y, Field RE (2009) Does computer navigation in total knee arthroplasty improve patient outcome at midterm follow-up? Int Orthop 33(6):1567–1570PubMedCrossRef
20.
Zurück zum Zitat Lüring C, Oczipka F, Perlick L, Tingart M, Grifka J, Bäthis H (2009) Two year follow-up comparing computer assisted versus freehand TKR on joint stability, muscular function and patients satisfaction. Knee Surg Sports Traumatol Arthrosc 17(3):228–232PubMedCrossRef Lüring C, Oczipka F, Perlick L, Tingart M, Grifka J, Bäthis H (2009) Two year follow-up comparing computer assisted versus freehand TKR on joint stability, muscular function and patients satisfaction. Knee Surg Sports Traumatol Arthrosc 17(3):228–232PubMedCrossRef
21.
Zurück zum Zitat Martin A, von Strempel A (2006) Two year outcomes of computed tomography-based and computed tomography free navigation for total knee arthroplasties. Clin Orthop Relat Res 449:275–282PubMed Martin A, von Strempel A (2006) Two year outcomes of computed tomography-based and computed tomography free navigation for total knee arthroplasties. Clin Orthop Relat Res 449:275–282PubMed
22.
Zurück zum Zitat Molfetta L, Caldo D (2008) Computer navigation versus conventional implantation for varus knee total arthroplasty: a case-control study at 5 years follow-up. Knee 15(2):75–79PubMedCrossRef Molfetta L, Caldo D (2008) Computer navigation versus conventional implantation for varus knee total arthroplasty: a case-control study at 5 years follow-up. Knee 15(2):75–79PubMedCrossRef
23.
Zurück zum Zitat Bellamy N, Campbell J, Stevens J, Pilch L, Stewart C, Mahmood Z (1997) Validation study of a computerized version of the Western Ontario and McMaster Universities VA 3.0 Osteoarthritis Index. J Rheumatol 24(12):2413–2415PubMed Bellamy N, Campbell J, Stevens J, Pilch L, Stewart C, Mahmood Z (1997) Validation study of a computerized version of the Western Ontario and McMaster Universities VA 3.0 Osteoarthritis Index. J Rheumatol 24(12):2413–2415PubMed
24.
Zurück zum Zitat Insall JN, Dorr LD, Scott R, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14PubMed Insall JN, Dorr LD, Scott R, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14PubMed
25.
Zurück zum Zitat Bachmeier C, March L, Cross M, Lapsley H, Tribe K, Courtenay BG et al (2001) A comparison of outcomes in osteoarthritis patients undergoing total hip and knee replacement surgery. Osteoarthritis Cartilage 9:137–146PubMedCrossRef Bachmeier C, March L, Cross M, Lapsley H, Tribe K, Courtenay BG et al (2001) A comparison of outcomes in osteoarthritis patients undergoing total hip and knee replacement surgery. Osteoarthritis Cartilage 9:137–146PubMedCrossRef
Metadaten
Titel
A five to seven year follow-up comparing computer-assisted vs freehand TKR with regard to clinical parameters
verfasst von
C. Lüring
M. Kauper
H. Bäthis
L. Perlick
J. Beckmann
J. Grifka
M. Tingart
B. Rath
Publikationsdatum
01.03.2012
Verlag
Springer-Verlag
Erschienen in
International Orthopaedics / Ausgabe 3/2012
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-011-1297-4

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