COMPUTER-ASSISTED TOTAL KNEE REPLACEMENT: TWO YEARS EXPERIENCE IN WESTERN AUSTRALIA

Introduction and Aims: The Western Australian experience with the introduction and use of two different computer assistance systems for total knee replacement is presented. Method: A multi-parameter CT assessment of TKR alignment has been devised. This has been used in a controlled cadaver study, a randomised controlled patient trial, two prospective clinical and radiological audits using the Stryker and the BrainLAB systems. A prospective audit of non-computer assisted TKRs is available for comparison. A total of 240 patients have had either primary or revision computer-assisted TKRs. Results: Both computer assistance systems provide some advantages in alignment over the non-CAS TKRs. They provide excellent control in revision operations where bone loss needs to be augmented with bone graft. There is however significant morbidity associated with anchoring pin sites. There are pitfalls in accepting software upgrades. The cost-benefit analysis still needs to done. Conclusion: Computer-assisted TKR has made a promising start but it is still in its infancy and the current versions may not be ready for widespread introduction