Postoperative Functional and Radiological Outcome Comparison of Computer-assisted and Conventional Total Knee Arthroplasty at 6 Months Follow-up: A Cross Sectional Study

Background:Computer-assisted navigation TKA has just been adapted in Indonesia for the last decade. The method is aiming to achieve more precise mechanical alignment in TKA. We conducted this study to compare the functional and radiological outcome of TKA using computer-assisted navigation with the conventional method. Method: Fifty elderly patients aged more than 50 years old with severe knee osteoarthritis (Kellgren Lawrence stage IV) who scheduled for TKA surgery in the first half of 2019 were consecutively sampled. All surgeries were done with standard medial parapatellar approach using Press-fit condylar (PFC) system total knee arthroplasty (Johnson & Johnson Professional, Raynham, MA). Brainlab Knee3 (version 3.2) navigation software was used for computer-assisted navigation group. All patients were measured at 6 months post-operative follow up for objective functional status with Western Ontario and McMaster Universities Index (WOMAC) and Oxford Knee Score (OKS). Weight-bearing, long-leg follow-up radiographs of both lower limbs were taken, and coronal tibiofemoral angle (CTFA), coronal femoral component angle (CFCA) and coronal tibial component angle (CTCA) were measured. Results: Group of computer-assisted navigation TKA surgery was found to have significantly lower WOMAC score (p<0.05) and higher OKS score (p<0.05). Although not statistically significant, greater angle of deviation is observed in the conventional TKA surgery group. Proportions with deviation of less than 3o were found more in the group using computer navigation. Conclusion. Patients who had TKA surgery under computer-assisted navigation would benefit a better functional outcome if compared with conventional TKA surgery, as measured with WOMAC and OKS. However, there is no significant difference in terms of radiographic value of coronal-plane mechanical deviation on both methods.

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