Τετάρτη 28 Οκτωβρίου 2020

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

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Abstract

Background

The radiological and clinical efficiency among robot‐assisted surgery (RAS), computer‐assisted navigation system (CAS) and conventional (CON) total knee arthroplasty (TKA) remains controversial.

Methods

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.

Results

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).< /p>

Conclusions

Technology‐based assistive techniques (CAS and RAS) may surpass the CON‐TKA, when considering higher radiological accuracy and comparable clinical outcomes.

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