No definite advantage of a portable accelerometer-based navigation system over conventional technique in total knee arthroplasty: A systematic review and meta-analysis.


Journal

Orthopaedics & traumatology, surgery & research : OTSR
ISSN: 1877-0568
Titre abrégé: Orthop Traumatol Surg Res
Pays: France
ID NLM: 101494830

Informations de publication

Date de publication:
06 2019
Historique:
received: 27 10 2018
revised: 06 03 2019
accepted: 07 03 2019
pubmed: 2 5 2019
medline: 11 4 2020
entrez: 2 5 2019
Statut: ppublish

Résumé

Precise implant alignment is a crucial prognostic factor in total knee arthroplasty (TKA). Portable navigation systems (PN-TKA) were reported to be better than the conventional technique (CON-TKA). We hypothesized that PN-TKA offered greater radiologic precision than CON-TKA in mechanically aligning components. We investigated whether (1) it improved global mechanical alignment, and (2) optimized component placement with respect to the tibial and femoral mechanical axes. A systematic literature review compared PN-TKA versus CON-TKA. PubMed, Web of Science and Cochrane Library search retrieved ten studies. Their data were pooled using RevMan 5.3. Odds ratios (OR) for dichotomous data were calculated with 95% confidence intervals (CIs) for each outcome. Statistical heterogeneity was assessed as I There were significantly fewer outliers for mechanical axis (I Although PN-TKA appeared to improve global alignment, it had no effect on coronal tibial alignment, which is a key factor in predicting the long-term success of component fixation. There thus appeared to be no definite advantage of PN-TKA over CON-TKA. III.

Sections du résumé

BACKGROUND
Precise implant alignment is a crucial prognostic factor in total knee arthroplasty (TKA). Portable navigation systems (PN-TKA) were reported to be better than the conventional technique (CON-TKA). We hypothesized that PN-TKA offered greater radiologic precision than CON-TKA in mechanically aligning components. We investigated whether (1) it improved global mechanical alignment, and (2) optimized component placement with respect to the tibial and femoral mechanical axes.
PATIENTS AND METHODS
A systematic literature review compared PN-TKA versus CON-TKA. PubMed, Web of Science and Cochrane Library search retrieved ten studies. Their data were pooled using RevMan 5.3. Odds ratios (OR) for dichotomous data were calculated with 95% confidence intervals (CIs) for each outcome. Statistical heterogeneity was assessed as I
RESULTS
There were significantly fewer outliers for mechanical axis (I
DISCUSSION
Although PN-TKA appeared to improve global alignment, it had no effect on coronal tibial alignment, which is a key factor in predicting the long-term success of component fixation. There thus appeared to be no definite advantage of PN-TKA over CON-TKA.
LEVEL OF EVIDENCE
III.

Identifiants

pubmed: 31040097
pii: S1877-0568(19)30113-6
doi: 10.1016/j.otsr.2019.03.006
pii:
doi:

Types de publication

Journal Article Meta-Analysis Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

619-626

Informations de copyright

Copyright © 2019 Elsevier Masson SAS. All rights reserved.

Auteurs

Tomonori Shigemura (T)

Department of Orthopaedic Surgery, Teikyo University Chiba Medical Center, 3426-3 Anesaki, 299-0111 Ichihara, Chiba, Japan. Electronic address: tshigepon@yahoo.co.jp.

Yasuaki Murata (Y)

Department of Orthopaedic Surgery, Teikyo University Chiba Medical Center, 3426-3 Anesaki, 299-0111 Ichihara, Chiba, Japan.

Yohei Yamamoto (Y)

Department of Orthopaedic Surgery, Teikyo University Chiba Medical Center, 3426-3 Anesaki, 299-0111 Ichihara, Chiba, Japan.

Norichika Mizuki (N)

Department of Orthopaedic Surgery, Teikyo University Chiba Medical Center, 3426-3 Anesaki, 299-0111 Ichihara, Chiba, Japan.

Yasunori Toki (Y)

Department of Orthopaedic Surgery, Teikyo University Chiba Medical Center, 3426-3 Anesaki, 299-0111 Ichihara, Chiba, Japan.

Yuichi Wada (Y)

Department of Orthopaedic Surgery, Teikyo University Chiba Medical Center, 3426-3 Anesaki, 299-0111 Ichihara, Chiba, Japan.

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