Trial reportKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2023
No advantage with navigated versus conventional mechanically aligned total knee arthroplasty-10 year results of a randomised controlled trial.
Trial report in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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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.
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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.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- Platform-Specific Learning Curves in Robotic-Assisted Total Knee Arthroplasty: A Systematic Review.Orthopaedic surgery · 2026Pooled it
- Correlation of revision rate of unicompartmental knee arthroplasty with total knee arthroplasty: a meta-analysis of clinical studies and worldwide arthroplasty registers.Archives of orthopaedic and trauma surgery · 2024Pooled it
- Impact of flexion contracture severity on early outcomes of computer-navigated total knee arthroplasty: a retrospective cohort study.Journal of orthopaedic surgery and research · 2026Article
- Efficacy of computer-assisted navigation in improving radiographic and clinical outcomes after total knee arthroplasty.Medicine · 2026Article
- How Likely Do Patients After Total Knee Arthroplasty with a Posterior-Stabilized Knee System Meet Their Desired Sport Activity Level?Journal of clinical medicine · 2026Article
- Is technological-assisted leg axis alignment reliable in total knee arthroplasty with varus-valgus deformities?European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Impact of navigation on functional and radiological outcomes after total knee arthroplasty: a retrospective analysis of one hundred and ninety cases.International orthopaedics · 2025Article
- Lateral Instability 13 Years After Kinematically Aligned Total Knee Arthroplasty.Arthroplasty today · 2025Article
- Accuracy and clinical outcomes in total knee arthroplasty using an image-free navigation system.Archives of orthopaedic and trauma surgery · 2025Article
- Mapping the reporting practices in recent randomised controlled trials published inJournal of experimental orthopaedics · 2025Article
- Comparison of the accuracy and efficacy of different assistive techniques in primary total knee arthroplasty: A network meta-analysis.Journal of experimental orthopaedics · 2024Article
- 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
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeComputer-assisted surgery (CAS) total knee arthroplasty (TKA) remains a controversial area of surgical practice. The aim of this study is to report the ten-year revision rates and patient-reported outcome measures (PROMS) of a single-blinded, prospective, randomised controlled trial comparing electromagnetically (EM) navigated and conventional TKA.
methods199 patients were randomised to receive either EM navigated or conventional TKA where the aim of implantation was neutral mechanical alignment in all cases. Ten-year revision rates were collated and compared between the two intervention groups. Longitudinal PROMS data was collected prospectively at various time points up to 10 years post-operatively.
resultsOver the ten-year period, there were 23 deaths (22.8%) in the EM navigation cohort and 30 deaths (30.6%) in the conventional cohort. At 10 years post-operatively, there was no statistically significant difference in all cause revision between the EM navigation and conventional cohort (4.0 vs 6.1%, p = 0.429). When analysing causes of revision that might be influenced by utilising EM navigation, there was no statistically significant difference in revisions (3.0% EM navigated vs 4.1% conventional group, p = 0.591). Patients that received navigated TKAs had improved Oxford Knee Society, American Knee Society Score and range of motion at 3 months following surgery compared to conventional TKA (p = 0.002, p = 0.032, and p = 0.05, respectively). However, from 1 to 10 years post-operatively, both interventions had equivalent outcomes.
conclusionThere is no difference in revision rates or clinical outcomes comparing EM navigated versus conventional TKA at ten-year follow-up. The expected mortality rate makes it unlikely that a difference in revision rates will reach statistical significance in the future. In the setting of an experienced knee arthroplasty surgeon, it is difficult to justify the additional costs of CAS in TKA surgery. LEVEL OF EVIDENCE: I.
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