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J Arthroplasty. 2014 May;29(5):938-44. doi: 10.1016/j.arth.2013.09.018. Epub 2013 Oct 18.

Imageless computer navigation in total knee arthroplasty provides superior short term functional outcomes: a meta-analysis.

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Department of Orthopaedic Surgery, Center for Hip and Knee Replacement (CHKR), New York-Presbyterian Hospital at Columbia University Medical Center, New York, New York.


Computer navigation in total knee arthroplasty (TKA) is intended to produce more reliable results, but its impact on functional outcomes has not been firmly demonstrated. Literature searches were performed for Level I randomized trials that compared TKA using imageless computer navigation to those performed with conventional instruments. Radiographic and functional outcomes were extracted and statistically analyzed. TKA performed with computer navigation was more likely to be within 3° of ideal mechanical alignment (87.1% vs. 73.7%, P < .01). Navigated TKAs had a higher increase in Knee Society Score at 3-month follow-up (68.5 vs. 58.1, P = .03) and at 12-32 month follow-up (53.1 vs. 45.8, P < .01). Computer navigation in TKA provides more accurate alignment and superior functional outcomes at short-term follow-up.


arthroplasty; computer navigation; knee; meta-analysis; total knee replacement

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