New technology-based assistive techniques in total knee arthroplasty: A Bayesian network meta-analysis and systematic review.

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Journal Article
The international journal of medical robotics + computer assisted surgery : MRCAS, 2020, 17, (2), pp. e2189
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The radiological and clinical efficiency among robot-assisted surgery (RAS), computer-assisted navigation system (CAS) and conventional (CON) total knee arthroplasty (TKA) remains controversial.


Bayesian network meta-analysis (NMA) and systematic review were performed to investigate radiological and clinical efficiency respectively. The certainty of the evidence was evaluated using GRADE and CERQual tool.


Thirty-four RCTs (7289 patients and 7424 knees) were included. The NMA showed that RAS-TKA had the highest probability for mechanical axis restoration (odds ratio for RAS vs. CAS 3.79, CrI 1.14 to 20.54, very low certainty), followed by CAS-TKA (odds ratio for CAS vs. CON 2.55, CrI 1.67 to 4.01, very low certainty) and then CON-TKA, without significant differences in other radiological parameters. No differences were found in clinical outcomes after qualitative systematic review (overall low certainty).


Technology-based assistive techniques (CAS and RAS) may surpass the CON-TKA, when considering higher radiological accuracy and comparable clinical outcomes. This article is protected by copyright. All rights reserved.
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