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Original ArticleOpen Access
Prospective Non-Randomized Comparative Clinical Outcome of Computer Assisted Total Knee Arthroplasty with and without a Minimally Invasive Approach
Leelasestaporn C 
Objective: Compare clinical outcomes of computer assisted total knee arthroplasty using the LCS® knee implant with(CAMITKA) and without (CATKA) minimally invasive surgery.
Material and Method: The author prospectively performed 71 computer-assisted total knee arthroplasties (TKA) in groupof the present study using the CiTM navigation system in a non-randomized manner.
Results: CAMITKA subjects had a mean operation time of 105 minutes, average incision length of 9.1 cm, mean total bloodloss of 541 ml, mean time to ambulation of 25.4 hours, and required approximately 10 and 18 days using walkers and canesrespectively, before ambulating unaided. CATKA subjects had a mean operation time of 81 minutes, average incision lengthof 13.5 cm, mean total blood loss of 599 ml, mean time to ambulation of 45.4 hours, and required 17 and 27.5 days usingwalkers and canes respectively, before ambulating unaided. All outcome differences have statistical significances, exceptblood loss. Mechanical axis alignment measured from post-operative radiographic assessment showed that 2.5% of all kneeswere outliers and average axis deviations were 1.39° and 1.34° for CAMITKA and CATKA subjects, respectively. Nocomplications were detected. CAMITKA is advantageous with respect to recovery time.
Conclusion: Minor surgical pitfalls were experienced with CAMITKA regarding visualization and initial registration of thenavigation system. However, they may be corrected by coupling navigation with CT scan, fluoroscopy, and/or ultrasound.Additionally, accurate mechanical axis alignment shows that computer assisted surgery technology allows minimal invasivesurgery in TKA because it allows visualization of areas not directly revealed without aid.
Keywords: Computer assisted surgery, CAS, Minimally invasive surgery, MIS, Total knee arthroplasty, TKA, Total kneereplacement, TKR
Material and Method: The author prospectively performed 71 computer-assisted total knee arthroplasties (TKA) in groupof the present study using the CiTM navigation system in a non-randomized manner.
Results: CAMITKA subjects had a mean operation time of 105 minutes, average incision length of 9.1 cm, mean total bloodloss of 541 ml, mean time to ambulation of 25.4 hours, and required approximately 10 and 18 days using walkers and canesrespectively, before ambulating unaided. CATKA subjects had a mean operation time of 81 minutes, average incision lengthof 13.5 cm, mean total blood loss of 599 ml, mean time to ambulation of 45.4 hours, and required 17 and 27.5 days usingwalkers and canes respectively, before ambulating unaided. All outcome differences have statistical significances, exceptblood loss. Mechanical axis alignment measured from post-operative radiographic assessment showed that 2.5% of all kneeswere outliers and average axis deviations were 1.39° and 1.34° for CAMITKA and CATKA subjects, respectively. Nocomplications were detected. CAMITKA is advantageous with respect to recovery time.
Conclusion: Minor surgical pitfalls were experienced with CAMITKA regarding visualization and initial registration of thenavigation system. However, they may be corrected by coupling navigation with CT scan, fluoroscopy, and/or ultrasound.Additionally, accurate mechanical axis alignment shows that computer assisted surgery technology allows minimal invasivesurgery in TKA because it allows visualization of areas not directly revealed without aid.
Keywords: Computer assisted surgery, CAS, Minimally invasive surgery, MIS, Total knee arthroplasty, TKA, Total kneereplacement, TKR
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