Background: The use of navigation remains a controversial topic in knee arthroplasty. The purpose of this study is to evaluate current rates of utilization of navigation in unicompartmental knee arthroplasty (UKA) in the United States, as well as the incidence of short-term complications and operative times between navigated and non-navigated UKA.
Methods: A query of the National Surgical Quality Improvement Project (NSQIP) database was used to identify cases of primary UKA during years 2006-2017. Additional common procedural terminology (CPT) codes were used to identify cases in which navigation was utilized. Operative time, length of stay, and short-term outcomes were compared. Propensity score matching was used to minimize differences in demographics and comorbidities between the navigation and non-navigation cohorts.
Results: A total of 10,586 cases of UKA were identified; 343 of these cases (3.2%) utilized navigation. The unadjusted rate of any complication for the entire cohort was 3.6%. Navigated UKA had mean operative times 8 minutes longer than non-navigated UKA (92.1 min vs. 84.3 min; p<0.001). There was no difference in overall complication rates between the matched navigated (3.5%) and non-navigated (3.2%) cohorts (p=0.65). There was no difference in rates of readmission (0.31% vs. 0.58%; p=0.31), reoperation (0.29% vs. 0.29%; p=1.00), and mean length of stay (1.3 ± 1.6 days vs. 1.2 ± 1.9 days; p=0.15).
Conclusion: UKA utilizing navigation had a mean operative time 8 minutes longer than non-navigated UKA. We found no difference in rates of short-term complications, readmission, reoperation, or mean length of stay between navigated and non-navigated UKA.Level of Evidence: III.
Keywords: computer; navigation; outcomes; unicompartmental knee arthroplasty.
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