Long-Term Results of Computer-Navigated Total Knee Arthroplasties Performed by Low-Volume and Less Experienced Surgeon

Lacko, Marek; Schreierová, D; Čellár, R; Vaško, G

doi:10.55095/achot2018/036

Cited by 7 publications

(1 citation statement)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of the 1,459 studies that were initially screened, 10 RCTs were ultimately included for analysis after screening and application of the eligibility criteria 15-24 (Fig. 2).…”

Section: Resultsmentioning

confidence: 99%

The Reverse Fragility Index: Interpreting the Current Literature on Long-Term Survivorship of Computer-Navigated Versus Conventional TKA

Shi

Mojica

Moverman

et al. 2022

Journal of Bone and Joint Surgery

View full text Add to dashboard Cite

Background: Despite the most recent American Academy of Orthopaedic Surgeons clinical practice guideline making a "strong" recommendation against the use of intraoperative navigation in total knee arthroplasty (TKA), its use is increasing. We utilized the concept of the reverse fragility index (RFI) to assess the strength of neutrality of the randomized controlled trials (RCTs) comparing the long-term survivorship of computer-navigated and conventional TKA.Methods: A systematic review was performed including all RCTs through August 3, 2021, comparing the long-term outcomes of computer-navigated and conventional TKA. Randomized trials with mean follow-up of >8 years and survivorship with revision as the end point were included. The RFI quantifies the strength of a study's neutrality by calculating the minimum number of events necessary to flip the result from nonsignificant to significant. The RFI at a threshold of p < 0.05 was calculated for each study reporting nonsignificant results. The reverse fragility quotient (RFQ) was calculated by dividing the RFI by the study sample size.Results: Ten clinical trials with 2,518 patients and 38 all-cause revisions were analyzed. All 10 studies reported nonsignificant results. The median RFI at the p < 0.05 threshold was 4, meaning that a median of 4 events would be needed to change the results from nonsignificant to significant. The median RFQ was 0.029, indicating that the nonsignificance of the results was contingent on only 2.9 events per 100 participants. The median loss to follow-up was 27 patients. In all studies, the number of patients lost to follow-up was greater than the RFI. Conclusions:The equipoise in long-term survivorship between computer-navigated and conventional TKA rests on fragile studies, as their statistical nonsignificance could be reversed by changing the outcome status of only a handful of patients--a number that was always smaller than the number lost to follow-up. Routine reporting of the RFI in trials with nonsignificant findings may provide readers with a measure of confidence in the neutrality of the results.

show abstract

“…Of the 1,459 studies that were initially screened, 10 RCTs were ultimately included for analysis after screening and application of the eligibility criteria 15-24 (Fig. 2).…”

Section: Resultsmentioning

confidence: 99%

The Reverse Fragility Index: Interpreting the Current Literature on Long-Term Survivorship of Computer-Navigated Versus Conventional TKA

Shi

Mojica

Moverman

et al. 2022

Journal of Bone and Joint Surgery

View full text Add to dashboard Cite

show abstract

Clinico-Radiological and Functional Results of the Navigated Gradius (Gradually Reducing Radius) Knee Prosthesis at Short to Mid-Term Follow-Up

Sharma

Dhanjani

Bashir

et al. 2020

IJOO

View full text Add to dashboard Cite

Background Navigated total knee replacements (TKR) have shown better knee function and quality of life. It also reduces revision rates. The aim of our study is to evaluate short to mid-term clinico-radiological and functional results, survival rate and complications of Gradius knee prosthesis implanted using computer navigation. Methods We retrospectively reviewed 120 Gradius knee prosthesis, implanted in 68 patients (52 bilateral TKR and 16 unilateral TKR) and followed from Jan 2015 till Jan 2020. Pre-operative & post-operative radiographs, knee society scores (KSS), range of motion (ROM), deformity assessment and gait video recordings were done for all patients. Results The mean follow-up was 3.8 years (minimum 2-5 years).The mean ROM was 2° (0-10) extension to 135° (128°-138°) flexion. The KSS pain score improved from mean of 38.3 (range 26-44) to 90.4 (mean 88-92). The KSS functional score improved from 36.2 (range 28-39) to 92.6 (range 86-94). All patients had excellent to good function during successive follow-ups. The coronal alignment improved from 8° varus to 0.3° varus. Sagittal alignment was corrected from 8° (4°-18°) preoperatively to 2° (0°-8°) postoperatively Conclusion At mid-term our series outlines the better functional and radiological results of Gradius knee prosthesis using navigation as a tool. We recommend a prospective randomized controlled trials comparing navigated versus non-navigated for Gradius knee prosthesis with long-term follow-up.

show abstract

Applications of artificial intelligence in Orthopaedic surgery: A systematic review and meta-analysis

Geda,

Tang,

Lee

2024

Engineering Applications of Artificial Intelligence

View full text Add to dashboard Cite

Long-Term Results of Computer-Navigated Total Knee Arthroplasties Performed by Low-Volume and Less Experienced Surgeon

Cited by 7 publications

References 22 publications

The Reverse Fragility Index: Interpreting the Current Literature on Long-Term Survivorship of Computer-Navigated Versus Conventional TKA

The Reverse Fragility Index: Interpreting the Current Literature on Long-Term Survivorship of Computer-Navigated Versus Conventional TKA

Clinico-Radiological and Functional Results of the Navigated Gradius (Gradually Reducing Radius) Knee Prosthesis at Short to Mid-Term Follow-Up

Applications of artificial intelligence in Orthopaedic surgery: A systematic review and meta-analysis

Contact Info

Product

Resources

About