Computer Navigated Total Knee Arthroplasty: Rates of Adoption and Early Complications

Abstract Background When new technologies are introduced, it is important to evaluate the rate of adoption and outcomes compared to pre-existing technology. The purpose of this study was to determine the adoption rate of computer assisted navigation in total knee arthroplasty (TKA), to determine if the short-term complication rate changed over time with navigation, and to compare short term-complication rates of navigated and traditional TKA. Methods The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database was used to identify 108,277 patients undergoing primary TKA between 2010 and 2014, of which 3,573 cases were navigated (3.30%). Rates of adoption of navigated TKA were determined. Differences in short-term complications by year were compared using propensity score matching. Results Navigation utilization decreased from 4.96% in 2010 to 3.06% in 2014. Blood transfusion rates for the entire cohort decreased from 19% in 2011 to 6% in 2014, and was not decreased with navigation compared to traditional TKA in 2014 (p = 0.1309). Operative time was not increased by navigation, and average 94.2 minutes. There were no significant differences in all-cause complications, reoperation rate, unplanned readmission, or length of stay for any year. Conclusions There was a 38.3% decrease in TKA navigation utilization from 2010 to 2014. Blood transfusion rates decreased 68% over the five year study, and were not decreased with navigation in 2014. Navigation was not found to increase operative time. There were no significant differences in short-term complications, readmission rate, or length of stay between navigated and traditional TKA.