CAS-TKA REDUCES THE OCCURRENCE OF FUNCTIONAL OUTLIERS

Abstract

The most reported benefit of TKA navigation technologies has been the reduction in limb and component alignment outliers. This improvement has not been shown to effect clinical outcomes. This study was designed to compare the functional outcomes between computer assisted techniques and manual techniques.

Each group had 60 patients with similar demographics. The average functional outcomes (SF-36, WOMAC, range of motion, pain relief, and knee society score) were the same.

The average scores of the SF-36, Knee Society Score, WOMAC were similar for the two groups. However, fewer patients in Group II reported visual analog pain scores greater than 40 at 6 wks, 3 mos and 6 mos. At 1 yr, the pain scores of the two groups were similar. Fewer patients in Group II had KSS scores less than 70 at 3 months, 80 at 6 months, and 90 at one year, than those in Group I. The average range of motion in Group II was greater by 8 degrees at 4 wks and 3 mos, but equal to the average ROM in Group I at 6 and 12 mos. However, the number of patients with less than 90 degrees of motion at each follow-up period was less in Group II than in Group I at each follow-up period. There were fewer superficial wound infections in Group II than in Group I.

The average functional outcomes were similar; the results indicate a consistent reduction in outliers in most measured parameters of functional outcomes. In particular, the guidelines for administering pain medication and providing physical therapy were similar for the two groups. The results of this study are parallel to the radiographic results comparing TKA’s performed with manual and computer assisted instrumentation. In those studies, a reduction in outliers was consistently associated with the use of computer assisted techniques.