| Objectives Computer-assisted navigation for total knee arthroplasty and traditional total knee arthroplasty in the same patient were performed a Meta-analysis to determine whether computer-assisted navigation could provide better imaging and clinical results.Methods Relevant content was extracted by searching databases including Wanfang Database,CNKI database,Embase database,Pub Med database and Cochrane Library database.The retrieval time is from the establishment of the database to February 31,2022.The retrieval languages are Chinese and English.According to the relevant database keywords and free words to design the retrieval.Literature screening a screening team consisting of two physicians strictly followed the procedures of Cochrane Handbook5.1 and independently conducted preliminary screening of literatures according to pre-set inclusion criteria and exclusion criteria.Two physicians read the full text to extract relevant data and basic information according to the outcome indicators included in the study.By the independent analysis of the literature of into two physicians,respectively control the Cochrane bias risk assessment standards of six projects(randomized method,allocation concealment,blind method,the result data integrity,selective reports the results of the study,and other sources of bias),categorizing quality evaluation: 5 or more for a low risk of bias;3 to 4 are moderate risk of bias;The risk of high bias is less than 3.Chisquare test of P and I~2 values to test the heterogeneity between different studies,When P>0.1 or I~2<50%,the heterogeneity among the studies is small,then the fixed effect model is used;when P<0.1 or I~2>50%,therefore,it is necessary to analyze the source of heterogeneity and adopt the random effect model.Results A total of 10 literatures were included,all of which were clinical controlled trials.There were 160 cases in the navigation group and 222 cases in the traditional group(RR=0.72,95%CI:0.60～0.87,P=0.0005);the analysis of outliers of femoral flexion Angle included 130 cases in the navigation group and 208 cases in the traditional group(RR=0.62,95%CI:0.45～0.83,P=0.002);tibial valgus Angle was analyzed in 127 cases in the navigation group and 164 cases in the traditional group(RR=0.78,95%CI:0.62-0.96,P=0.02);there were 122 cases in the navigation group and 141 cases in the conventional group(RR=0.87,95%CI:0.69～1.09,P=0.22);the analysis of outliers of tibial flexion Angle included 142 cases in the navigation group and 167 cases in the traditional group(RR=0.85,95%CI:0.69～1.05,P=0.13);western Ontario and Mc Master University osteoarthritis Index scores included 1027 in the navigation group and 1027 in the traditional group(MD=-0.45,95%CI:-1.75～0.84,P=0.49);the range of motion was 563 in the navigation group and 563 in the conventional group(MD=-0.08,95%CI:-1.13～0.98,P=0.89);there were 26 cases in the revision navigation group and 22 cases in the traditional group(RR=1.18,95%CI:0.69-2.02,P=0.55);there were 26 cases in navigation group and 22 cases in traditional group(RR=1.18,95%CI:0.69-2.02,P=0.55).Conclusions The accuracy of navigation in lower limb force line,femoral flexion Angle and tibial valgus Angle is higher than that of traditional surgery.There were no statistically significant differences between navigational and conventional procedures in femoral valus Angle,tibial flexion Angle,western Ontario and Mc Master University osteoarthritis index scores,range of motion,complications,or revision numbers.Figure16;Table3;Reference 122... |
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