PMID- 35923307
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220805
IS  - 0019-5413 (Print)
IS  - 1998-3727 (Electronic)
IS  - 0019-5413 (Linking)
VI  - 56
IP  - 8
DP  - 2022 Aug
TI  - Computer-Assisted Surgery Enables Beginner Surgeons, Under Expert Guidance, to 
      Achieve Long-Term Clinical Results not Inferior to Those of a Skilled Surgeon in 
      Knee Arthroplasty.
PG  - 1439-1448
LID - 10.1007/s43465-022-00666-9 [doi]
AB  - PURPOSE: The purpose of this study is to determine whether the use of a surgical 
      navigation system in total knee replacement (TKR) enables beginner and 
      intermediate surgeons to achieve clinical PROM outcomes as good as those 
      conducted by expert surgeons in the long term. METHODS: We enrolled 100 
      consecutive patients whose total navigated knee arthroplasty (TKA) was performed 
      in our institution from 2008 to 2010. According to the principal surgeon's 
      surgical experience, the patients were divided into three groups: (1) beginner 
      surgeons, with no more than 30 previous knee replacement performances, (2) 
      intermediate surgeons, with more than 30 but not more than 300, and (3) expert 
      surgeons, with more than 300 knee replacements. Demographic data collected on the 
      cohort included gender, laterality, age, and body mass index (BMI). The outcome 
      measures assessed were Forgotten Joint Score (FJS), implant positioning, limb 
      alignment, and prosthesis survival rate. A margin of equivalence of +/- 18.5 points 
      in the FJS scale was prespecified in terms of the minimal clinically important 
      difference (MCID) to compare the FJS results obtained in the long period between 
      the groups of interest. RESULTS: The mean follow-up was 11.10 +/- 0.78, 
      10.86 +/- 0.66, and 11.30 +/- 0.74 years, respectively, for each of the groups. The 
      long-term FJS mean score was 80.86 +/- 21.88, 81.36 +/- 23.87, and 90.48 +/- 14.65 for 
      each group. The statistical analysis proved noninferiority and equivalence in 
      terms of the FJS results reported in the long term by patients in Groups 1 or 2 
      compared to those in Group 3. More specifically, it has been proved that the mean 
      difference between groups is within the interval of equivalence defined in terms 
      of the MCID. The overall prostheses survival rate was 93.7%. CONCLUSION: 
      Navigated assisted TKA, under expert guidance, can be as effective when performed 
      by beginner or intermediate surgeons as performed by senior surgeons regarding 
      the accuracy of implant positioning, limb alignment, and long-term clinical 
      outcome.
CI  - (c) The Author(s) 2022.
FAU - Larrainzar-Garijo, Ricardo
AU  - Larrainzar-Garijo R
AUID- ORCID: 0000-0002-0501-2006
AD  - Orthopedic and Trauma Department, Hospital Universitario Infanta Leonor, C/ Gran 
      Via Este 80, 28031 Madrid, Spain. GRID: grid.414761.1
AD  - Departamento Cirugia, Facultad de Medicina, Universidad Complutense Madrid, 
      Madrid, Spain. GRID: grid.4795.f. ISNI: 0000 0001 2157 7667
FAU - Molanes-Lopez, Elisa M
AU  - Molanes-Lopez EM
AD  - Unidad Departamental de BioestadisticaDepartamento de Estadistica e Investigacion 
      Operativa, Facultad de Medicina, Universidad Complutense Madrid, Madrid, Spain. 
      GRID: grid.4795.f. ISNI: 0000 0001 2157 7667
FAU - Canones-Martin, Miguel
AU  - Canones-Martin M
AD  - Orthopedic and Trauma Department, Hospital Universitario Infanta Leonor, C/ Gran 
      Via Este 80, 28031 Madrid, Spain. GRID: grid.414761.1
FAU - Murillo-Vizuete, David
AU  - Murillo-Vizuete D
AD  - Orthopedic and Trauma Department, Hospital Universitario Infanta Leonor, C/ Gran 
      Via Este 80, 28031 Madrid, Spain. GRID: grid.414761.1
FAU - Valencia-Santos, Natalia
AU  - Valencia-Santos N
AD  - Departamento Cirugia, Facultad de Medicina, Universidad Complutense Madrid, 
      Madrid, Spain. GRID: grid.4795.f. ISNI: 0000 0001 2157 7667
FAU - Garcia-Bogalo, Raul
AU  - Garcia-Bogalo R
AD  - Orthopedic and Trauma Department, Hospital Universitario Infanta Leonor, C/ Gran 
      Via Este 80, 28031 Madrid, Spain. GRID: grid.414761.1
FAU - Corella-Montoya, Fernando
AU  - Corella-Montoya F
AD  - Orthopedic and Trauma Department, Hospital Universitario Infanta Leonor, C/ Gran 
      Via Este 80, 28031 Madrid, Spain. GRID: grid.414761.1
AD  - Departamento Cirugia, Facultad de Medicina, Universidad Complutense Madrid, 
      Madrid, Spain. GRID: grid.4795.f. ISNI: 0000 0001 2157 7667
LA  - eng
PT  - Journal Article
DEP - 20220622
PL  - Switzerland
TA  - Indian J Orthop
JT  - Indian journal of orthopaedics
JID - 0137736
PMC - PMC9283583
OTO - NOTNLM
OT  - Arthroplasty
OT  - Computer-assisted
OT  - Dynamic alignment
OT  - Femorotibial mechanical angle
OT  - Kinematic
OT  - Knee
OT  - Knee prosthesis
OT  - Replacement
COIS- Conflict of InterestThe author R. Larrainzar-Garijo is a paid consultant who 
      receives royalties from B-Braun Aesculap. The other authors have no conflicts of 
      interest to declare concerning this study.
EDAT- 2022/08/05 06:00
MHDA- 2022/08/05 06:01
PMCR- 2022/06/22
CRDT- 2022/08/04 02:16
PHST- 2022/01/29 00:00 [received]
PHST- 2022/05/23 00:00 [accepted]
PHST- 2022/08/04 02:16 [entrez]
PHST- 2022/08/05 06:00 [pubmed]
PHST- 2022/08/05 06:01 [medline]
PHST- 2022/06/22 00:00 [pmc-release]
AID - 666 [pii]
AID - 10.1007/s43465-022-00666-9 [doi]
PST - epublish
SO  - Indian J Orthop. 2022 Jun 22;56(8):1439-1448. doi: 10.1007/s43465-022-00666-9. 
      eCollection 2022 Aug.