Computer-Assisted Navigation Software Advancements Improve the Accuracy of Total Knee Arthroplasty

The purpose of this study was to evaluate the effectiveness of software advancements in improving total knee component positioning and limb alignment when using computer-aided navigation. A single total joint fellowship-trained surgeon performed unilateral total knee arthroplasty on 315 patients using conventional techniques or with assistance from computer navigation software. Preoperative and postoperative x-ray measurements were taken and analyzed. Our previous work demonstrated a statistically significant improvement (P < .02) in limb alignment (+/- 3 degrees of biomechanical neutral) when using version 2.0 software (93%) when compared with conventional techniques (82%). Further improvement was demonstrated with the version 3.1 software (99%, P < .03). The tourniquet times were recorded for each group and showed a significant improvement with the 3.1 software (conventional = 74 minutes, 2.0 navigation = 90 minutes, and 3.1 navigation = 73 minutes). The Stryker 2.0 software (Stryker Orthopedics, Mahwah, NJ) tourniquet time was statistically significantly longer than either the conventional or the 3.1 group (P < .001). Outcomes-based studies will be required to see if these factors will lead to improved patient function and/or prolonged prosthetic survival rates.