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New technology‐based assistive techniques in total knee arthroplasty: A Bayesian network meta‐analysis and systematic review
Author(s) -
Gao Jiaxiang,
Dong Shengjie,
Li Jiao Jiao,
Ge Long,
Xing Dan,
Lin Jianhao
Publication year - 2021
Publication title -
the international journal of medical robotics and computer assisted surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.556
H-Index - 53
eISSN - 1478-596X
pISSN - 1478-5951
DOI - 10.1002/rcs.2189
Subject(s) - radiological weapon , medicine , meta analysis , total knee arthroplasty , odds ratio , bayesian network , odds , systematic review , surgery , medline , computer science , artificial intelligence , logistic regression , political science , law
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 Grading of Recommendations, Assessment, Development and Evaluation and Confidence in the Evidence from Reviews of Qualitative tools. 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, credible interval [CrI] 1.14–20.54, very low certainty), followed by CAS‐TKA (odds ratio for CAS vs. CON 2.55, CrI 1.67–4.01, 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). Conclusions Technology‐based assistive techniques (CAS and RAS) may surpass the CON‐TKA, when considering higher radiological accuracy and comparable clinical outcomes.