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[Computer-assisted knee arthroplasty: comparison with a conventional procedure. Results of 50 cases in a prospective randomized study].
Rev Chir Orthop Reparatrice Appar Mot. 2001 Feb 01; 87(1):18-28.RC

Abstract

PURPOSE OF THE STUDY

The aim of this work was to compare the radiographic findings after two techniques for total knee arthroplasty, one using a computer-assisted approach and the other a conventional approach.

MATERIAL AND METHODS

Between January 1998 and April 1999, we conducted a prospective study randomizing 25 patients for conventional surgery (group A) and 25 for computer-assisted surgery (group B). All patients volunteered to participate in this study and gave their written informed consent. There were 35 women and 15 men, mean age 69.5 years (range 47-85). The two groups were comparable for age, gender, height, weight, orthopedic history, etiology and preoperative mobility. The preoperative hip-knee angle (HKA) was also comparable between the two groups. Mean HKA was 175 degrees, i.e. 5 degrees varus (range 162 degrees (18 degrees varus) to 210 degrees (30 degrees valgus)). Genu varum was found in 80 p. 100 of the patients in group A and in 76 p. 100 in group B, genu valgum in 16 p. 100 in group A and 24 p. 100 in group B. The same operator performed all the procedures) with the same type ok prosthesis for all patients. The goal of the operation was to position the prosthesis to produce an HKA of 180 +/- 3 degrees, a femoral angle of 90 degrees (from the mechanical axis), a tibial angle of 90 degrees and a posterior tibial slope of 0 degrees (tibial plateau at 90 degrees to the lateral tibial axis). Statview 5 PC was used for the statistical analysis. Comparisons between groups were made with the Student's t test to compare means when the validity conditions were met.

RESULTS

The patients were reviewed by two surgeons, independently of the operator and the designers of the computer-assistance program. Mean duration of the procedure was longer in group B (102 mn versus 70 mn, p<0.001). There was no statistically significant difference in mean postoperative bleeding (group A=380 cc, group B=480 cc). The postoperative HKA was 181.2 +/- 2.72 degrees in group A and 179.04 +/- 2.53 degrees in group B (p > 0.05). The HKA was between 177 degrees and 183 degrees in 75 p. 100 of the patients in group A and in 84 p. 100 of those in group B. Implantation of the femoral component showed a mean angle of 91.12 +/- 2.07 degrees in group A and 89.56 +/- 1.61 degrees in group B (p=0.048). The mean tibial angle was 90.167 +/- 1.61 degrees in group A and 89.5 +/- 1.34 degrees in group B (p=0.11). On the lateral view, the femoral component was at 90 degrees to the mechanical axis in 16/21 patients in group B. These data were missing in group A. The posterior tibial slope was 90.76 +/- 2.19 degrees in group A and 89.44 +/- 2.14 in group B (p=0.18).

CONCLUSION

Computer-assisted surgery for total knee arthroplasty was found to provide remarkably reliable results. Once the "growing pains" of this new material have been mastered, all surgeons should be able to expect an improvement in the positioning of prosthetic implantations.

Authors+Show Affiliations

Service de Chirurgie Orthopédique et de Traumatologie du Sport, CHU de Grenoble, Hôpital Sud, 38130 Echirolles.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
English Abstract
Journal Article
Randomized Controlled Trial

Language

fre

PubMed ID

11240534

Citation

Saragaglia, D, et al. "[Computer-assisted Knee Arthroplasty: Comparison With a Conventional Procedure. Results of 50 Cases in a Prospective Randomized Study]." Revue De Chirurgie Orthopedique Et Reparatrice De L'appareil Moteur, vol. 87, no. 1, 2001, pp. 18-28.
Saragaglia D, Picard F, Chaussard C, et al. [Computer-assisted knee arthroplasty: comparison with a conventional procedure. Results of 50 cases in a prospective randomized study]. Rev Chir Orthop Reparatrice Appar Mot. 2001;87(1):18-28.
Saragaglia, D., Picard, F., Chaussard, C., Montbarbon, E., Leitner, F., & Cinquin, P. (2001). [Computer-assisted knee arthroplasty: comparison with a conventional procedure. Results of 50 cases in a prospective randomized study]. Revue De Chirurgie Orthopedique Et Reparatrice De L'appareil Moteur, 87(1), 18-28.
Saragaglia D, et al. [Computer-assisted Knee Arthroplasty: Comparison With a Conventional Procedure. Results of 50 Cases in a Prospective Randomized Study]. Rev Chir Orthop Reparatrice Appar Mot. 2001 Feb 1;87(1):18-28. PubMed PMID: 11240534.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Computer-assisted knee arthroplasty: comparison with a conventional procedure. Results of 50 cases in a prospective randomized study]. AU - Saragaglia,D, AU - Picard,F, AU - Chaussard,C, AU - Montbarbon,E, AU - Leitner,F, AU - Cinquin,P, PY - 2001/3/10/pubmed PY - 2001/5/22/medline PY - 2001/3/10/entrez SP - 18 EP - 28 JF - Revue de chirurgie orthopedique et reparatrice de l'appareil moteur JO - Rev Chir Orthop Reparatrice Appar Mot VL - 87 IS - 1 N2 - PURPOSE OF THE STUDY: The aim of this work was to compare the radiographic findings after two techniques for total knee arthroplasty, one using a computer-assisted approach and the other a conventional approach. MATERIAL AND METHODS: Between January 1998 and April 1999, we conducted a prospective study randomizing 25 patients for conventional surgery (group A) and 25 for computer-assisted surgery (group B). All patients volunteered to participate in this study and gave their written informed consent. There were 35 women and 15 men, mean age 69.5 years (range 47-85). The two groups were comparable for age, gender, height, weight, orthopedic history, etiology and preoperative mobility. The preoperative hip-knee angle (HKA) was also comparable between the two groups. Mean HKA was 175 degrees, i.e. 5 degrees varus (range 162 degrees (18 degrees varus) to 210 degrees (30 degrees valgus)). Genu varum was found in 80 p. 100 of the patients in group A and in 76 p. 100 in group B, genu valgum in 16 p. 100 in group A and 24 p. 100 in group B. The same operator performed all the procedures) with the same type ok prosthesis for all patients. The goal of the operation was to position the prosthesis to produce an HKA of 180 +/- 3 degrees, a femoral angle of 90 degrees (from the mechanical axis), a tibial angle of 90 degrees and a posterior tibial slope of 0 degrees (tibial plateau at 90 degrees to the lateral tibial axis). Statview 5 PC was used for the statistical analysis. Comparisons between groups were made with the Student's t test to compare means when the validity conditions were met. RESULTS: The patients were reviewed by two surgeons, independently of the operator and the designers of the computer-assistance program. Mean duration of the procedure was longer in group B (102 mn versus 70 mn, p<0.001). There was no statistically significant difference in mean postoperative bleeding (group A=380 cc, group B=480 cc). The postoperative HKA was 181.2 +/- 2.72 degrees in group A and 179.04 +/- 2.53 degrees in group B (p > 0.05). The HKA was between 177 degrees and 183 degrees in 75 p. 100 of the patients in group A and in 84 p. 100 of those in group B. Implantation of the femoral component showed a mean angle of 91.12 +/- 2.07 degrees in group A and 89.56 +/- 1.61 degrees in group B (p=0.048). The mean tibial angle was 90.167 +/- 1.61 degrees in group A and 89.5 +/- 1.34 degrees in group B (p=0.11). On the lateral view, the femoral component was at 90 degrees to the mechanical axis in 16/21 patients in group B. These data were missing in group A. The posterior tibial slope was 90.76 +/- 2.19 degrees in group A and 89.44 +/- 2.14 in group B (p=0.18). CONCLUSION: Computer-assisted surgery for total knee arthroplasty was found to provide remarkably reliable results. Once the "growing pains" of this new material have been mastered, all surgeons should be able to expect an improvement in the positioning of prosthetic implantations. SN - 0035-1040 UR - https://www.unboundmedicine.com/medline/citation/11240534/[Computer_assisted_knee_arthroplasty:_comparison_with_a_conventional_procedure__Results_of_50_cases_in_a_prospective_randomized_study]_ DB - PRIME DP - Unbound Medicine ER -