TY - JOUR
T1 - Functional outcomes following total knee arthroplasty: A randomised trial comparing computer-assisted surgery with conventional techniques
T2 - a randomised trial comparing computer-assisted surgery with conventional techniques
AU - Blakeney, William G
AU - Khan, Riaz J K
AU - Palmer, Jennifer L
N1 - Crown Copyright © 2013. Published by Elsevier B.V. All rights reserved.
PY - 2014/3
Y1 - 2014/3
N2 - Background: A number of trials have shown improved radiological alignment following total knee arthroplasty using computer-assisted surgery (CAS) compared with conventional surgery. Few studies, however, have looked at functional outcomes. Methods: We prospectively studied a cohort of 107 patients that underwent TKA by a single surgeon. Patients were randomised into 3 groups: computer-assisted surgery for both the femur and the tibia, intramedullary guides for both the femur and the tibia, and an intramedullary guide for the femur and an extramedullary guide for the tibia.Patients were followed-up post-operatively with the Short Form Health Survey (SF-12) and Oxford Knee Score (OKS) questionnaires. Results: At a median follow-up of 46. months (range 30-69. months), there was a trend towards higher OKS results in the CAS group, with a mean score of 40.6 in the CAS group compared to 37.6 in the extramedullary group and 36.8 in the intramedullary group. The difference seen in the OKS between CAS and the conventional groups had a significant unadjusted p-value (0.024), and approached significance when adjusted for age and sex (0.054). There was a significant improvement in the OKS when the mechanical axis was within ±. 3° of neutral, versus those outside this range (median of 41.0 compared to 38.3, p=0.045). Discussion: This study shows that clinically significant differences are being seen in functional scores of patients treated with CAS versus conventional guides, at medium-term follow up. Our findings reinforce the tenet that a coronal mechanical axis of within 3° of neutral equates to significantly better functional outcomes. © 2013.
AB - Background: A number of trials have shown improved radiological alignment following total knee arthroplasty using computer-assisted surgery (CAS) compared with conventional surgery. Few studies, however, have looked at functional outcomes. Methods: We prospectively studied a cohort of 107 patients that underwent TKA by a single surgeon. Patients were randomised into 3 groups: computer-assisted surgery for both the femur and the tibia, intramedullary guides for both the femur and the tibia, and an intramedullary guide for the femur and an extramedullary guide for the tibia.Patients were followed-up post-operatively with the Short Form Health Survey (SF-12) and Oxford Knee Score (OKS) questionnaires. Results: At a median follow-up of 46. months (range 30-69. months), there was a trend towards higher OKS results in the CAS group, with a mean score of 40.6 in the CAS group compared to 37.6 in the extramedullary group and 36.8 in the intramedullary group. The difference seen in the OKS between CAS and the conventional groups had a significant unadjusted p-value (0.024), and approached significance when adjusted for age and sex (0.054). There was a significant improvement in the OKS when the mechanical axis was within ±. 3° of neutral, versus those outside this range (median of 41.0 compared to 38.3, p=0.045). Discussion: This study shows that clinically significant differences are being seen in functional scores of patients treated with CAS versus conventional guides, at medium-term follow up. Our findings reinforce the tenet that a coronal mechanical axis of within 3° of neutral equates to significantly better functional outcomes. © 2013.
KW - Aged
KW - Arthroplasty, Replacement, Knee/methods
KW - Double-Blind Method
KW - Female
KW - Femur/diagnostic imaging
KW - Follow-Up Studies
KW - Humans
KW - Knee Joint/diagnostic imaging
KW - Male
KW - Patient Outcome Assessment
KW - Prospective Studies
KW - Surgery, Computer-Assisted
KW - Tibia/diagnostic imaging
KW - Tomography, X-Ray Computed
UR - http://www.scopus.com/inward/record.url?scp=84897465666&partnerID=8YFLogxK
U2 - 10.1016/j.knee.2013.04.001
DO - 10.1016/j.knee.2013.04.001
M3 - Article
C2 - 24703685
SN - 0968-0160
VL - 21
SP - 364
EP - 368
JO - The Knee
JF - The Knee
IS - 2
ER -