ArticleJournal of orthopaedics
Technical and surgical causes of outliers after computer navigated total knee arthroplasty.
Article in Journal of orthopaedics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 8 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed.
- Total knee replacement with an accelerometer-based, hand-held navigation system improves knee alignment: reliable in all patients.Archives of orthopaedic and trauma surgery · 2024Article
- Computer-Assisted Intramedullary Nailing of Intertrochanteric Fractures Did Not Prevent Tip-Apex Distance Outliers.Journal of clinical medicine · 2023Article
- Clinical and Radiological Outcomes of Computer-Assisted versus Conventional Total Knee Arthroplasty at 5-Year Follow-Up: Is There Any Benefit?Journal of personalized medicine · 2023Article
- A new robotically assisted technique can improve outcomes of total knee arthroplasty comparing to an imageless navigation system.Archives of orthopaedic and trauma surgery · 2023Article
- Computer Navigation Assisted Restricted Kinematic Alignment Improves Short-Term Outcomes in Total Knee Arthroplasty: An Ambispective Cohort Study.Orthopaedic surgery · 2023Article
- Notching is less, if femoral component sagittal positioning is planned perpendicular to distal femur anterior cortex axis, in navigated TKA.Knee surgery & related research · 2021Article
- After 25 years of computer-navigated total knee arthroplasty, where do we stand today?Arthroplasty (London, England) · 2021Review
- The accelerometer-based navigation system demonstrated superior radiological outcomes in restoring mechanical alignment and component sagittal positioning in total knee arthroplasty.BMC musculoskeletal disorders · 2021Article
Corrections and comments
- Erratum issued
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNavigated total knee arthroplasty (TKA) improves implant and limb alignment but outliers continue to exist. This study aimed to determine the technical and surgical causes of outliers.
methodsThis retrospective cohort study included 208 patients who had undergone navigated TKA. Limb and implant alignment indices were measured on post-operative CT scans: mechanical femoro-tibial angle (MFTA); coronal femoral angle (CFA); coronal tibial angle (CTA); sagittal femoral angle (SFA); and sagittal tibial angle (STA). Values outside 0°±3° for MFTA and SFA, 90°±3° for CFA, CTA and STA were considered outliers. Intra-operative navigation data and CT scans were evaluated to categorize the causes of sagittal and coronal plane outliers into hip centre error; ankle centre error; heterogeneous tibial cement mantle; malalignment accepted by surgeon; suboptimal knee balance; and no obvious explanation.
resultsOf the 1040 measurements (five per TKA), the overall incidence of outliers was 10.4% (n = 108). Femoral component outliers (CFA + SFA, n = 51) were all attributable to hip centre error. Tibial component outliers (CTA + STA, n = 43) were attributable to ankle centre error (n = 6), heterogeneous cement mantle (n = 20), malalignment accepted by the surgeon (n = 6) and no obvious cause (n = 11). MFTA outliers were attributable to hip centre error (n = 4) or suboptimal knee balance (n = 10).
conclusionsSurgeon related errors can be minimized by a meticulous operative technique. These results indicate scope for additional technical improvement, especially in hip centre acquisition, which may further reduce the incidence of outliers.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.