Thesis

Functional assessment to compare electromagnetic navigated and conventional total knee arthroplasty

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Awarding institution
  • University of Strathclyde
Date of award
  • 2011
Thesis identifier
  • T12923
Qualification Level
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Department, School or Faculty
Abstract
  • Navigated Total Knee Arthroplasty (TKA) aims to improve implantation accuracy and longevity of the prosthesis. The potential functional benefits of navigated TKA have not been fully explored using an objective measurement system. This thesis presents the results from 38 navigated and 39 conventional patients within a randomized controlled trial aimed at comparing electromagnetic navigated and conventional TKA. They were functionally assessed at 1 year post operation. The assessment included a kinematic evaluation using flexible electrogoniometry, calculation of the hamstring and quadriceps moment while the knee joint was flexed to 90ยบ, an activity level assessment using an activity monitor and clinical and functional questionnaires. The alignment of the prosthesis within the two surgical groups was analysed using CT scans and a long leg double stance weight bearing radiograph. From the results, it was concluded that both patient groups had significant functional limitation compared to age matched 'normal' subjects. There were no significant differences between the two surgical groups in terms of clinical questionnaire scores or activity levels. The navigated group resulted in significantly higher knee joint flexion angles during the pre swing phase of level and slope walking. The female navigated group had significantly higher hamstring and quadriceps moments compared to the female conventional TKA group. This difference was not found between the male navigated and conventional groups. Post operation CT analysis showed significant improvement in frontal femoral and sagittal femoral alignment in the navigated TKA group. The relationship between alignment and functional outcome was investigated to determine whether alignment is a predictor of functional outcome. The clinical scores indicated better function in the 'well aligned' mechanical axis group compared to the 'outlier' group but it failed to reach statistical significance. It was concluded that the difference in the post operation function of the two surgical groups remains minimal despite the better alignment achieved using navigation. Proving cost effectiveness for navigation systems in TKA remains a challenge.
Advisor / supervisor
  • Rowe, Philip
Resource Type
DOI
EThOS ID
  • uk.bl.ethos.549412
Date Created
  • 2011
Former identifier
  • 834200
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