Are There Differences in Accuracy or Outcomes Scores Among Navigated, Robotic, Patient-specific Instruments or Standard Cutting Guides in TKA? A Network Meta-analysis.

Clinical Orthopaedics and Related Research
Pierre-Alban BouchéRémy Nizard

Abstract

Several kinds of cutting guides, including patient-specific instrumentation, navigation, standard cutting guides, accelerometer-based navigation, and robotic guidance, are available to restore a planned alignment during TKA. No previous study has simultaneously compared all of these devices; a network meta-analysis is an especially appealing method because it allows comparisons across approaches that were not compared head-to-head in individual randomized controlled trials. We performed a network meta-analysis to determine whether novel approaches to achieving implant alignment, such as patient-specific instrumentation, navigation, accelerometer-based navigation, and robotic guidance, provide any advantage over standard cutting guides in terms of: (1) hip-knee-ankle (HKA) alignment outliers greater than ± 3°, (2) outcome scores (1989 - Knee Society Score and WOMAC score) measured 6 months after surgery, or (3) femoral and tibial implant malalignment (greater than ± 3°), taken separately, in the frontal and sagittal plane, as well as other secondary outcomes including validated outcome scores 1 and 2 years after surgery. In our network meta-analysis, we included randomized controlled trials comparing the different cutting guides...Continue Reading

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Citations

Dec 3, 2020·The Journal of Bone and Joint Surgery. American Volume·Michael J Taunton
Aug 12, 2021·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Jean-Yves JennyMichael T Hirschmann
Aug 18, 2021·Archives of Orthopaedic and Trauma Surgery·Seth S Leopold
Nov 16, 2021·The Journal of Bone and Joint Surgery. American Volume·Jesus M VillaCarlos A Higuera-Rueda

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