Navigated versus non-navigated total knee arthroplasty: A large single-implant cohort analysis of clinical outcomes and survivorship

IF 2.7 Q2 ORTHOPEDICS

Journal of Experimental Orthopaedics Pub Date : 2025-09-04 DOI:10.1002/jeo2.70408

Alessandro Carrozzo, Régis Pailhé, Ophélie Manchec, Sebastien Lustig, Émilie Bérard, Etienne Cavaignac

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Abstract

Purpose

The aim of this study was to compare implant survival, clinical outcomes and radiographic alignment between navigated and non-navigated total knee arthroplasty (TKA) performed with a single implant system.

Methods

A retrospective multicenter analysis of prospectively collected data from 6078 TKAs performed for primary osteoarthritis using a single implant system was performed. Procedures were divided into two groups: navigated (n = 3602) and non-navigated (n = 2476). The primary outcome was implant survival. Secondary outcomes included re-intervention rates, patient-reported outcomes measures (PROMs, International Knee Society scores), and range of motion.

Results

Five-year implant survival was similar between the non-navigated (98.9%; 95% confidence interval [CI], 98.2%–99.3%) and navigated (98.3%; 95% CI, 97.6%–98.8%) groups (p = 0.505). After adjustment for potential confounders, navigated procedures showed a slightly higher risk of surgical reintervention excluding infection (hazard ratio 1.42, 95% CI: 1.02–1.96, p = 0.036). PROM analyses were restricted to patients with both baseline and 5-year questionnaires (n = 470). The improvement of patient-reported functional outcomes at 5 years was not significantly different between groups (p = 0.893 after adjustment for potential confounders).

Conclusions

Navigation was equivalent to conventional instrumentation TKA with respect to implant survival. After adjusting for confounders and excluding septic revisions, navigated procedures showed a slightly higher reoperation risk. No significant advantage in functional outcomes was observed at mid-term follow-up. These findings do not support a clear clinical benefit for routine use of navigation in this setting.

Level of Evidence

Level III, retrospective comparative study.

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导航与非导航全膝关节置换术：临床结果和生存率的大型单植入队列分析

目的：本研究的目的是比较采用单一种植体系统的导航和非导航全膝关节置换术（TKA）的种植体存活率、临床结果和影像学对齐。方法回顾性多中心分析前瞻性收集的6078例使用单一植入系统治疗原发性骨关节炎的tka数据。手术分为两组：导航（n = 3602）和非导航（n = 2476）。主要结局是种植体存活。次要结果包括再干预率、患者报告的结果测量（PROMs、国际膝关节协会评分）和活动范围。结果无导航组（98.9%，95%可信区间[CI]， 98.2% ~ 99.3%）和导航组（98.3%,95% CI, 97.6% ~ 98.8%）种植体5年生存率相似（p = 0.505）。在对潜在混杂因素进行校正后，导航手术显示排除感染后手术再干预的风险略高（风险比1.42,95% CI: 1.02-1.96, p = 0.036）。PROM分析仅限于基线和5年问卷调查的患者（n = 470）。患者报告的5年功能结果的改善在两组间无显著差异（调整潜在混杂因素后p = 0.893）。结论在种植体成活率方面，导航与常规器械TKA相当。在调整混杂因素和排除脓毒性修复后，导航程序显示再手术风险略高。在中期随访中未观察到功能预后方面的显著优势。这些发现并不支持在这种情况下常规使用导航的明确临床益处。证据等级III级，回顾性比较研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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