Postoperative morbidity and mortality following total knee arthroplasty with computer navigation

Browne, James A.; Cook, Chad; Hofmann, Aaron A.; Bolognesi, Michael P.

doi:10.1016/j.knee.2009.08.002

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Volume 17, Issue 2 , Pages 152-156, March 2010

Postoperative morbidity and mortality following total knee arthroplasty with computer navigation

James A. Browne
- Division of Orthopaedic Surgery, Department of Surgery, Duke University Medical Center, DUMC Box 3000, Trent Drive, Duke Clinics Building, Durham, NC 27710, United States
- Corresponding author. Division of Orthopaedic Surgery, DUMC Box 3000, Orange Zone, Duke Clinics Building, Trent Drive, Duke University Medical Center, Durham, NC 27710, United States. Tel.: +1 919 684 3170; fax: +1 919 6817672.
Chad Cook
- Centers of Excellence in Surgical Outcomes, Department of Surgery, Duke University Medical Center, DUMC Box 3907, Durham, NC 27710, United States
Aaron A. Hofmann
- Department of Orthopedic Surgery, University of Utah School of Medicine, Salt Lake City, Utah 84132, United States
Michael P. Bolognesi
- Division of Orthopaedic Surgery, Department of Surgery, Duke University Medical Center, DUMC Box 3269, Room 5316, Duke Clinics Building, Durham, NC 27710, United States

Received 11 February 2009; received in revised form 15 June 2009; accepted 2 August 2009. published online 16 September 2009.

Abstract

The incidence of postoperative complications following computer navigated total knee arthroplasty is unknown. There is no published evidence to support decreased morbidity compared to standard conventional technique. The Nationwide Inpatient Sample database was used to identify 101,596 patients who underwent total knee arthroplasty in 2005. Of these patients, 1156 were coded as having a computer-assisted procedure. Bivariate analysis and regression modeling were used to compare postoperative in-hospital outcomes between the computer-assisted and non-navigated cohorts. We found no differences in postoperative mortality or complications for the majority of our measured outcomes. Under multivariate regression analysis, computer navigation was associated with a lower rate of postoperative cardiac complications (odds ratio 0.40, p=0.042), a shorter length of stay, and a trend towards fewer hematomas. Further clinical study is required to examine the possible association of computer navigation with postoperative morbidity following knee arthroplasty.