Computerized Versus Traditional Approaches for Total Knee Arthroplasty: A Quantitative Analysis of Knee Society Score and Western Ontario and McMaster Universities Osteoarthritis Index

Abstract

Total knee arthroplasty (TKA) is a common surgery for osteoarthritis, with increasing prevalence expected in the near future. This systematic review and meta-analysis compared the effectiveness of computerized TKA versus traditional TKA, focusing on postoperative outcomes measured by the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and the Knee Society score (KSS). A search on PubMed and Cochrane databases on November 14, 2023 for retrospective randomized controlled trials (RCTs) yielded data on WOMAC and KSS. The search strategy was predefined, and methodological quality of studies was critically appraised. Two researchers extracted data. Unpaired t-testing assessed the mean monthly changes in KSS and WOMAC for computer-aided versus traditional TKA. Review Manager 5.3 was used for data synthesis and analysis. Out of 729 records, five RCTs enrolling 339 patients were eligible and analyzed using a random effects meta-analysis. The mean monthly ΔKSS score differed significantly between the traditional and computerized groups (11.47 ± 8.76 vs. 9.26 ± 6.05, respectively; p < 0.01). However, the pooled mean difference estimate showed no significant differences (D = 0.20, 95% CI = –0.53 to 0.93, p = 0.59), with high heterogeneity (I² = 85%, p < 0.001). The mean monthly ΔWOMAC score also differed significantly (–14.18 ± 21.54 vs. –18.43 ± 20.65, respectively; p < 0.05), but again, no significant differences were found in the pooled estimate (D = 0.17, 95% CI = –0.46 to 0.79, p = 0.60), with moderate heterogeneity (I² = 28%, p = 0.24).There is no significant difference in KSS or WOMAC outcomes between traditional and computerized TKA. The study suggests the need for further research with longer follow-up periods, more timepoints, and a broader range of patient outcome measures to fully evaluate the advantages and disadvantages of each method.

Keywords

Computerized TKA / KSS / Traditional TKA / WOMAC

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2024 The Author(s). Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.