{"title":"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","authors":"Alessandro Carrozzo, Régis Pailhé, Ophélie Manchec, Sebastien Lustig, Émilie Bérard, Etienne Cavaignac","doi":"10.1002/jeo2.70408","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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 (<i>n</i> = 3602) and non-navigated (<i>n</i> = 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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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 (<i>p</i> = 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, <i>p</i> = 0.036). PROM analyses were restricted to patients with both baseline and 5-year questionnaires (<i>n</i> = 470). The improvement of patient-reported functional outcomes at 5 years was not significantly different between groups (<i>p</i> = 0.893 after adjustment for potential confounders).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Level of Evidence</h3>\n \n <p>Level III, retrospective comparative study.</p>\n </section>\n </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70408","citationCount":"0","resultStr":"{\"title\":\"Navigated versus non-navigated total knee arthroplasty: A large single-implant cohort analysis of clinical outcomes and survivorship\",\"authors\":\"Alessandro Carrozzo, Régis Pailhé, Ophélie Manchec, Sebastien Lustig, Émilie Bérard, Etienne Cavaignac\",\"doi\":\"10.1002/jeo2.70408\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Purpose</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>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 (<i>n</i> = 3602) and non-navigated (<i>n</i> = 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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>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 (<i>p</i> = 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, <i>p</i> = 0.036). PROM analyses were restricted to patients with both baseline and 5-year questionnaires (<i>n</i> = 470). The improvement of patient-reported functional outcomes at 5 years was not significantly different between groups (<i>p</i> = 0.893 after adjustment for potential confounders).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Level of Evidence</h3>\\n \\n <p>Level III, retrospective comparative study.</p>\\n </section>\\n </div>\",\"PeriodicalId\":36909,\"journal\":{\"name\":\"Journal of Experimental Orthopaedics\",\"volume\":\"12 3\",\"pages\":\"\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-09-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70408\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Experimental Orthopaedics\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://esskajournals.onlinelibrary.wiley.com/doi/10.1002/jeo2.70408\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Experimental Orthopaedics","FirstCategoryId":"1085","ListUrlMain":"https://esskajournals.onlinelibrary.wiley.com/doi/10.1002/jeo2.70408","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Navigated versus non-navigated total knee arthroplasty: A large single-implant cohort analysis of clinical outcomes and survivorship
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.