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Knee

REDUCED RESPIRATORY MORBIDITY AND SHORTER POSTOPERATIVE STAY - THE REAL REASON TO NAVIGATE IN TOTAL KNEE ARTHROPLASTY?

British Association for Surgery of the Knee (BASK)



Abstract

Aim

We aim to compare post-operative length of stay and cardiopulmonary morbidity in patients randomised to either navigated or conventional total knee arthroplasty (TKA).

Method

Patients undergoing primary TKA for osteoarthritis were prospectively assigned randomly to either navigation-guided or control groups and blinded to this.

All patients received a PFC implant (DePuy, Warsaw, IN). In the control group the standard femoral intramedullary and tibial extramedullary alignment rod was used. In the navigation group, the BrainLab (Munich, Germany) navigation system was used. All operations were carried out by one of two consultant orthopaedic knee surgeons.

Length of post operative hospital stay and the development of cardiopulmonary complication were recorded and groups compared.

Results

95 patients were recruited (53 control vs 42 navigated). Patient demographics were similar in both groups.

Mean length of stay was 7 days in the control group (range 3-101), 5 days in the navigation group (range 3-10). The mode was 4 days in both groups.

7 patients(13%) stayed for >7 days in the control group, 3 patients (2%) stayed >7 days in the navigation group(p=0.339).

4 patients(8%) required >10 days inpatient stay in the control group, 0 patients required to stay in hospital for longer than 10 days in the navigation group(p=0.069).

The causes for the length of stay exceeding 10 days were pulmonary embolus in 3 patients, and chest infection in 1 patient.

Conclusions

Patients undergoing navigation-guided TKA required shorter post-operative inpatient stays than those undergoing arthroplasty using conventional techniques. Fewer patients in the navigation group required stays longer than 7 or 10 days. The difference in post-operative stay was associated with fewer respiratory complications in the navigated group.