{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T15:42:01Z","timestamp":1791906121254,"version":"4.3.4"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Am Acad Orthop Surg","JAAOS"],"published-print":{"date-parts":[[2020,10,15]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The goal of computer navigation in total knee arthroplasty (TKA) is to improve the accuracy of alignment. However, the relationship between this technology and implant longevity has not been established. The purpose of this study was to analyze survivorship of computer-navigated TKAs compared with traditionally instrumented TKAs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The PearlDiver Medicare database was used to identify patients who underwent a primary TKA using conventional instrumentation versus computer navigation between 2005 and 2014. Conventional and computer-navigated cohorts were matched by age, sex, year of procedure, comorbidities, and geographic region. Kaplan-Meier curves were generated to estimate survivorship with aseptic mechanical complications, periprosthetic joint infection, and all-cause revision as end points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      During the study period, 75,709 patients who underwent a computer-navigated TKA were identified and matched to a cohort of 75,676 conventional TKA patients from a cohort of 1,607,803 conventional TKA patients. No difference existed in survival between conventional instrumentation (94.7%) and navigated TKAs (95.1%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.06) at 5 years. A modest decrease was found in revisions secondary to mechanical complications associated with navigation (96.1%) compared with conventional instrumentation (95.7%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.02) at 5 years. No differences in revision rates because of periprosthetic joint infection were observed (97.9% versus 97.9% event-free survival,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.30). In a subgroup of Medicare patients younger than 65 years of age, use of computer navigation was associated with a decrease in all-cause revision (91.4% versus 89.6% event free survival,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.01) and revision secondary to mechanical complications (89.6% versus 87.8% event-free survival,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.01) at 5 years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>Among Medicare patients, no notable difference existed in TKA survival associated with the use of computer navigation at the 5-year follow-up. Use of computer navigation was associated with a slight decrease in revisions secondary to mechanical failure. Although improved survivorship was associated with patients younger than 65 years of age who had a navigated TKA, generalizability of these findings is limited given the unique characteristics of this Medicare subpopulation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5435\/jaaos-d-19-00548","type":"journal-article","created":{"date-parts":[[2020,1,14]],"date-time":"2020-01-14T04:29:01Z","timestamp":1578976141000},"page":"857-864","source":"Crossref","is-referenced-by-count":24,"title":["Population-based Survivorship of Computer-navigated Versus Conventional Total Knee Arthroplasty"],"prefix":"10.5435","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2704-4743","authenticated-orcid":false,"given":"Joseph K.","family":"Antonios","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3320-0386","authenticated-orcid":false,"given":"Hyunwoo Paco","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Djani","family":"Robertson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel A.","family":"Oakes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay R.","family":"Lieberman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathanael D.","family":"Heckmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,1,10]]},"reference":[{"issue":"7 suppl 3","key":"R1-20230714","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.arth.2005.05.009","article-title":"Computer assisted navigation in total knee arthroplasty: Comparison with conventional methods","volume":"20","author":"Anderson","year":"2005","journal-title":"J Arthroplasty"},{"key":"R2-20230714","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1302\/0301-620X.86B5.14927","article-title":"Alignment in total knee arthroplasty. 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arthroplasty","volume":"96","author":"Meehan","year":"2014","journal-title":"J Bone Joint Surg Am"},{"key":"R14-20230714","doi-asserted-by":"crossref","first-page":"2878","DOI":"10.1007\/s11999-014-3686-7","article-title":"The Elixhauser comorbidity method outperforms the Charlson index in predicting inpatient death after orthopedic surgery","volume":"472","author":"Menendez","year":"2014","journal-title":"CORR"},{"key":"R15-20230714","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1038\/sj.bmt.1705727","article-title":"Competing risk analysis using R: An easy guide for clinicians","volume":"40","author":"Scrucca","year":"2007","journal-title":"Bone Marrow Transplant"},{"key":"R16-20230714","first-page":"2255","article-title":"Influence of computer navigation on TKA revision rates","volume":"36","author":"Schnurr","year":"2012","journal-title":"SICOT"},{"key":"R17-20230714","doi-asserted-by":"crossref","first-page":"71","DOI":"10.5034\/inquiryjrnl_40.1.71","article-title":"Patterns of health care and disability for Medicare beneficiaries under 65","volume":"40","author":"Riley","year":"2003","journal-title":"Inquiry"},{"key":"R18-20230714","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.hjdsi.2016.11.002","article-title":"Segmenting high-cost Medicare patients into potentially actionable cohorts","volume":"5","author":"Joynt","year":"2017","journal-title":"Healthcare"},{"key":"R20-20230714","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.2106\/JBJS.17.01221","article-title":"Cross-linked polyethylene for total hip arthroplasty markedly reduces revision surgery at 16 years","volume":"100","author":"de Steiger","year":"2018","journal-title":"J Bone Joint Surg Am"}],"container-title":["Journal of the American Academy of Orthopaedic Surgeons"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.5435\/JAAOS-D-19-00548","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T14:40:10Z","timestamp":1787668810000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.5435\/JAAOS-D-19-00548"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,10]]},"references-count":19,"journal-issue":{"issue":"20","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.5435\/jaaos-d-19-00548","relation":{},"ISSN":["1067-151X","1940-5480"],"issn-type":[{"value":"1067-151X","type":"print"},{"value":"1940-5480","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,10]]}}}