These authors compared the revision rates and functional outcomes following total knee arthroplasty performed with either computer assisted surgery (CAS) or conventional instrumentation.
The data were analyzed by comparing 2 cohorts of patients: those managed by high-volume surgeons who routinely used CAS (“routine CAS” surgeons) and those managed by high-volume surgeons who routinely used conventional instrumentation (“routine conventional” surgeons).
The mean duration of follow-up was 4.5 years (range, 0 to 12 years).
The revision rate per 100 component-years was 0.437 for the “routine CAS” surgeons, compared with 0.440 for the “routine conventional” surgeons (p = 0.724).
Comment: The cost of CAS includes that of preoperative imaging, special instrumentation and increased operating time. At a time when health care resources are precious, one must ask whether these incremental costs are justified by better outcomes than those achieved with standard instrumentation.
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The revision rate per 100 component-years was 0.437 for the “routine CAS” surgeons, compared with 0.440 for the “routine conventional” surgeons (p = 0.724).
For patients <65 years of age, the revision rate per 100 component years was equivalent for the “routine CAS” and “routine conventional” surgeons (0.585 compared with 0.508; p = 0.524).
The OKS scores were similar at 6 months (38.88 compared with 38.52; p = 0.172), 5 years (42.26 compared with 41.77; p = 0.206), and 10 years (41.59 compared with 41.74; p = 0.893) when comparing the 2 cohorts.
The OKS scores were similar at 6 months (38.88 compared with 38.52; p = 0.172), 5 years (42.26 compared with 41.77; p = 0.206), and 10 years (41.59 compared with 41.74; p = 0.893) when comparing the 2 cohorts.
Surgeons who had performed >50 TKAs with use of CAS took 10 minutes longer on average than those who used conventional instrumentation (92 compared with 82 minutes; p = 0.012).
Comment: The cost of CAS includes that of preoperative imaging, special instrumentation and increased operating time. At a time when health care resources are precious, one must ask whether these incremental costs are justified by better outcomes than those achieved with standard instrumentation.
We have a new set of shoulder youtubes about the shoulder, check them out at this link.
Be sure to visit "Ream and Run - the state of the art" regarding this radically conservative approach to shoulder arthritis at this link and this link
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You may be interested in some of our most visited web pages arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
