Low incidence of postoperative complications with navigated total knee arthroplasty

• Published in: The Journal of arthroplasty Vol. 32; no. 7; pp. 2120 - 2126
• Main Authors: Brown, M.J., M.D, Matthews, J., M.D, Bayers-Thering, M., MS, MBA, Phillips, M., M.D, Krackow, K., M.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2017
• Subjects: Aged; arthroplasty; Arthroplasty, Replacement, Knee - adverse effects; Bone Nails; complications; computer-assisted; Female; Femoral Fractures - diagnostic imaging; Humans; Incidence; Male; Middle Aged; navigation; New York - epidemiology; Orthopedics; Postoperative Complications - diagnostic imaging; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Postoperative Period; Retrospective Studies; Surgery, Computer-Assisted - adverse effects; Tibial Fractures - diagnostic imaging; total knee arthroplasty; Total knee arthroplasty; navigation; complications; arthroplasty; computer-assisted; total knee arthroplasty
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2017.01.045

Abstract Background A number of postoperative complications of navigated total knee arthroplasty have been discussed in the literature, including tracker pin site infection and fracture. In this paper we discuss the low postoperative complication rate in a series of 3100 navigated total knee arthroplasties and the overall complication rate in a systematic analysis of the literature. Methods 3100 consecutive patients with navigated total knee arthroplasties from 2001 to 2016 were retrospectively evaluated for complications specific to navigation. We discuss the two cases of postoperative fracture through tracker pin sites that we experienced and compare this systematically to the literature. Results Postoperatively, our 3100 patient cohort experienced a total of two fractures through pin sites for an incidence of 0.065%. One was a distal femoral fracture which was treated surgically, and the other was a proximal tibial fracture treated nonoperatively. Due to our incorporation of the tracker sites within our operative incision, there were no identifiable pin site infections which others have noted at an incidence of 0.47%. Our 0.065% fracture rate compares favorably with the 0.16% rate of fracture published in the literature. Conclusion There is an extremely low risk of perioperative complications due to the instrumentation used in navigated total knee arthroplasty when utilizing the Stryker Navigation System and 4.0 mm anchoring pins placed within the surgical incision.