Same outcomes found for conventional and computer-aided knee-replacement surgery

Computer navigation delivers no apparent benefits to joint performance or survivability, research finds
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Computer-navigated knee-replacement surgery provides no better long-term outcomes than standard surgical techniques, according to a study published in the Journal of Bone & Joint Surgery.
 
Researchers in South Korea studied 520 patients with osteoarthritis who had computer-navigated surgery on one knee and conventional surgery on the other, assessing comparative results at three months, one year, and annually for 10 to 12 years.
 
The researchers found no difference in clinical function, alignment or survivorship of the joint-replacement components at any of the milestone checks, according to the report. Nor were there significant differences between the length of incision, blood loss during surgery or drainage following surgery, according to an announcement from the American Academy of Orthopaedic Surgeons describing the findings.
 
The only significant difference noted between the two surgeries was in the amount of time in which surgeons used a tourniquet to minimize bleeding, which was longer during computer-navigated surgery.
 
"The effect of computer-navigated total knee arthroplasty compared with conventional total knee arthroplasty on long-term implant survival remains unproven," said Young-Hoo Kim, M.D., of the Joint Replacement Center at Ewha Womans University School of Medicine in Seoul.
 
A separate study published earlier this year in the Journal of Clinical Oncology found no significant differences in the rate of complication rates for robotic hysterectomies versus laparoscopic hysterectomies.  The big difference was in price: nearly $1,300 more for the robotic surgery.
 
In an editorial accompanying that study, a gynecologic oncologist and consultant for the creator of the da Vinci surgical robot, said it's too early to give up on the technology.
 
"How will we ever advance innovative technology in surgery if we cannot understand and accept the associated start-up costs?" wrote Memorial Sloan Kettering Cancer Center's Mario Leitao, M.D.
 
To learn more:
- check out the JBJS study
- read the AAOS announcement
 
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