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Clinical Orthopaedics and Related Research®

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01-10-2014 | Survey

Does Imageless Computer-assisted TKA Lead to Improved Rotational Alignment or Fewer Outliers? A Systematic Review

Authors: Marrigje F. Meijer, BSc (Med), Inge H. F. Reininga, PhD, Alexander L. Boerboom, MD, Sjoerd K. Bulstra, MD, PhD, Martin Stevens, PhD

Published in: Clinical Orthopaedics and Related Research® | Issue 10/2014

Abstract

Background

Computer-assisted surgery (CAS) has been developed to enhance prosthetic alignment during primary TKAs. Imageless CAS improves coronal and sagittal alignment compared with conventional TKA. However, the effect of imageless CAS on rotational alignment remains unclear.

Questions/purposes

We conducted a systematic and qualitative review of the current literature regarding the effectiveness of imageless CAS during TKA on (1) rotational alignment of the femoral and tibial components and tibiofemoral mismatch in terms of deviation from neutral rotation, and (2) the number of femoral and tibial rotational outliers.

Methods

Data sources included PubMed, MEDLINE, and EMBASE. Study selection, data extraction, and methodologic quality assessment were conducted independently by two reviewers. Standardized mean difference with 95% CI was calculated for continuous variables (rotational alignment of the femoral or tibial component and tibiofemoral mismatch). To compare the number of outliers for femoral and tibial component rotation, the odds ratio and 95% CI were calculated. The literature search produced 657 potentially relevant studies, 17 of which met the inclusion criteria. One study was considered as having high methodologic quality, 15 studies had medium, and one study had low quality.

Results

Conflicting evidence was found for all outcome measures except for tibiofemoral mismatch. Moderate evidence was found that imageless CAS had no influence on postoperative tibiofemoral mismatch. The measurement protocol for measuring tibial rotation varied among the studies and in only one of the studies was the sample size calculation based on one of the outcome measures used in our systematic review.

Conclusions

More studies of high methodologic quality and with a sample size calculation based on the outcome measures will be helpful to assess whether an imageless CAS TKA improves femoral and tibial rotational alignment and tibiofemoral mismatch or decreases the number of femoral and tibial rotational outliers. To statistically analyze the results of different studies, the same measurement protocol should be used among the studies.

Available only for authorised users

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Title: Does Imageless Computer-assisted TKA Lead to Improved Rotational Alignment or Fewer Outliers? A Systematic Review
Authors: Marrigje F. Meijer, BSc (Med)
Inge H. F. Reininga, PhD
Alexander L. Boerboom, MD
Sjoerd K. Bulstra, MD, PhD
Martin Stevens, PhD
Publication date: 01-10-2014
Publisher: Springer US
Published in: Clinical Orthopaedics and Related Research® / Issue 10/2014
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-014-3688-5

2024 ASCO Annual Meeting

Springer Medicine

Does Imageless Computer-assisted TKA Lead to Improved Rotational Alignment or Fewer Outliers? A Systematic Review

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

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