Computer Navigated Total Knee Arthroplasty: Rates of Adoption and Early Complications

J Joseph Gholson; Kyle R Duchman; Jesse E Otero; Andrew J Pugely; Yubo Gao; John J Callaghan

doi:10.1016/j.arth.2017.01.034

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Computer Navigated Total Knee Arthroplasty: Rates of Adoption and Early Complications

Journal article

Peer reviewed

Computer Navigated Total Knee Arthroplasty: Rates of Adoption and Early Complications

J Joseph Gholson, Kyle R Duchman, Jesse E Otero, Andrew J Pugely, Yubo Gao and John J Callaghan

The Journal of arthroplasty, Vol.32(7), pp.2113-2119

07/2017

DOI: 10.1016/j.arth.2017.01.034

PMID: 28366310

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Abstract

When new technologies are introduced, it is important to evaluate the rate of adoption and outcomes compared with preexisting technology. The purpose of this study was to determine the adoption rate of computer-assisted navigation in total knee arthroplasty (TKA), to determine if the short-term complication rate changed over time with navigation, and to compare short-term complication rates of navigated and traditional TKA. The American College of Surgeons National Surgical Quality Improvement Program database was used to identify 108,277 patients undergoing primary TKA between 2010 and 2014, of which 3573 cases (3.30%) were navigated. Rates of adoption of navigated TKA were determined. Differences in short-term complications by year were compared using propensity score matching. Navigation utilization decreased from 4.96% in 2010 to 3.06% in 2014. Blood transfusion rates for the entire cohort decreased from 19% in 2011 to 6% in 2014, and was not decreased with navigation compared with traditional TKA in 2014 (P = .1309). Operative time was not increased by navigation, and average 94.2 minutes. There were no significant differences in all-cause complications, reoperation rate, unplanned readmission, or length of stay for any year. There was a 38.3% decrease in TKA navigation utilization from 2010-2014. Blood transfusion rates decreased 68% over the 5-year study, and were not decreased with navigation in 2014. Navigation was not found to increase operative time. There were no significant differences in short-term complications, readmission rate, or length of stay between navigated and traditional TKA.

Arthroplasty, Replacement, Knee - statistics & numerical data

Reoperation

United States - epidemiology

Postoperative Complications - etiology

Arthroplasty, Replacement, Knee - adverse effects

Surgery, Computer-Assisted - statistics & numerical data

Humans

Middle Aged

Male

Postoperative Complications - epidemiology

Blood Transfusion - statistics & numerical data

Operative Time

Propensity Score

Surgery, Computer-Assisted - adverse effects

Quality Improvement

Female

Aged

Databases, Factual

Details

Title: Subtitle: Computer Navigated Total Knee Arthroplasty: Rates of Adoption and Early Complications
Creators: J Joseph Gholson - Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Kyle R Duchman - Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Jesse E Otero - Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Andrew J Pugely - Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Yubo Gao - Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa
John J Callaghan - Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Resource Type: Journal article
Publication Details: The Journal of arthroplasty, Vol.32(7), pp.2113-2119
Publisher: United States
DOI: 10.1016/j.arth.2017.01.034
PMID: 28366310
ISSN: 0883-5403
eISSN: 1532-8406
Language: English
Date published: 07/2017
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation; Internal Medicine
Record Identifier: 9984040002402771

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