Navigation in TKA - effects in life quality, functional scores and economics - a prospective randomized study

摘要

Introduction: Use of navigation in total knee arthroplasty (TKA) results in reliable and reproducible alignment for mechanical leg axis as shown in different studies. This may improve the surgical results and patient satisfaction. Nevertheless the new technology is costly and budget in health care are limited. Therefore sole improvement in radiological parameters is not sufficient to justify the investments in actual health care systems and political economics. Complication rates, OR time constraint, functional scores like the KSS and WOMAC or global health surveys measuring life quality like the SF 36 are important factors ecological economical valuation. Methods: In a randomized clinical study we compared the navigation controlled alignment (group 1) with standard instrumentation (group 2) for the Innex~(TM) knee system and the Natural Knee II~R -System (Zimmer, Warsaw, US) using the Navitrack~R TotalKnee~(TM) (Orthosoft, Montreal, Canada). All surgerie were done from one experienced surgeon. Preoperativ, 3 and 6 month postoperativ the SF 36 health survey, the WOMAC and the KSS were queried. Mechanical axis, component alignment for tibial and femoral component were measured in long bone x-rays. Surgery time, blood loss and complications has been recorded to estimate possible effects in economics.