Abstract
INTRODUCTION
To test whether there are differences in postoperative mechanical and component alignment, and in functional results, between conventional, navigated and patient-specific total knee arthroplasties in a low-volume centre?
MATERIAL AND METHODS
Retrospective cohort study of 391 patients who received conventional, navigated or patient- specific primary cemented TKA in a low-volume hospital.
RESULTS
The risk of mechanical alignment outliers was 89% lower in the navigated group compared to the conventional TKA group. There was a 63% lower risk of femoral component malalignment and a 66% lower risk of tibial component malalignment in the navigated group. No significant reduction in the risk of malalignment was seen in the patient-specific group. Total WOMAC and Oxford scores were no different between the three techniques. The patient-specific group reported better WOMAC pain scores. PSI TKA was 33% more expensive than conventional TKA and 28% more expensive than Navigated TKA.
DISCUSSION
Navigated TKA improved alignment, but neither navigated nor patient-specific TKA improved functional outcomes. Patient-specific TKA was more expensive, with little additional benefit. Clinical relevance: The routine use of patient-specific instrumentation in low-volume centers is not supported by the currently available data.
