The Journal of Bone and Joint Surgery (American). 2009;91:116-130.
doi:10.2106/JBJS.H.01549
© 2009 The Journal of Bone and Joint Surgery, Inc.
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Computer-Assisted Minimally Invasive Total Knee Arthroplasty Compared with Standard Total Knee Arthroplasty

Surgical Technique

Andrew Quoc Dutton, MBBS, FRCS1 and Seng-Jin Yeo, MBBS, FRCS2

1 Department of Orthopaedic Surgery, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Republic of Singapore. E-mail address: andrew_dutton{at}hotmail.com
2 Department of Orthopaedic Surgery, Singapore General Hospital, Outram Road, Singapore 169608, Republic of Singapore. E-mail address: yeo.seng.jin{at}sgh.com.sg

Investigation performed at Singapore General Hospital, Republic of Singapore

The original scientific article in which the surgical technique was presented was published in JBJS Vol. 90-A, pp. 2-9, January 2008

DISCLOSURE: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. A commercial entity (DePuy) paid or directed in any one year, or agreed to pay or direct, benefits of less than $10,000 to a research fund, foundation, division, center, clinical practice,

A video supplement to this article will be availa ble from the Video Journal of Orthopaedics. A video clip will be available at the JBJS web site, www.jbjs.org. The Video Journal of Orthopaedics can be contacted at (805) 962-3410, web site: www.vjortho.com.

BACKGROUND: There is little information on the feasibility of computer navigation when using a minimally invasive approach for total knee arthroplasty, during which the anatomic landmarks for registration may be obscured. The purpose of the present study was to determine the radiographic accuracy of this technique and to compare the rate of functional recovery between patients who underwent computer-assisted minimally invasive arthroplasty and those who underwent conventional total knee arthroplasty.

METHODS: One hundred and eight consecutive patients were randomized to undergo computer-assisted minimally invasive total knee arthroplasty or conventional total knee arthroplasty. Perioperative pain management was standardized. The clinical parameters, long-leg radiographs, and functional assessment scores were evaluated for six months postoperatively.

RESULTS: Patients who underwent computer-assisted minimally invasive total knee arthroplasty had a significantly longer operative time (by a mean of twenty-four minutes) and a significantly shorter inpatient stay (3.3 compared with 4.5 days) in comparison with those who underwent conventional arthroplasty (p 0.001). Significantly more patients in the computer-assisted minimally invasive total knee arthroplasty group were able to walk independently for more than thirty minutes at one month (p = 0.04). The percentage of patients with a coronal tibiofemoral angle within ±3° of the ideal was 92% for the computer-assisted minimally invasive total knee arthroplasty group, compared with 68% for the conventional total knee arthroplasty group (p = 0.003).

CONCLUSIONS: Although specific clinical parameters reflect an early increased rate of functional recovery in association with computer-assisted minimally invasive total knee arthroplasty within the first postoperative month, the main advantage of this technique over conventional total knee arthroplasty is improved postoperative radiographic alignment without increased short-term complications.

LEVEL OF EVIDENCE: Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.


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