title: Does computer navigation system really improve early clinical outcomes after anterior cruciate ligament reconstruction? A meta-analysis and systematic review of randomized controlled trials.
abstract: Inaccurate tunnel placement is an important cause of failure in conventional anterior cruciate ligament (ACL) reconstruction. Controversy currently exists over the usefulness of computer-assisted navigation systems in addressing this problem. Five randomized or quasi-randomized, controlled trials comparing computer-navigated versus conventional technique in ACL reconstructions until December 1, 2009 were identified through a systematical database search. The clinical outcomes of the trials were analyzed by Lachman test, pivot-shift test, International Knee Documentation Committee knee score, Lysholm score, and Tegner score. Mean difference or risk ratio with 95% confidence interval was calculated using a fixed-effects or random-effects model. Heterogeneity across the studies was also assessed. We found that the use of computer-assisted navigation systems led to additional operative time (8-17min). No significant differences between computer-navigated and conventional groups were found in terms of knee stability and functional assessment during short-term follow-up. The role of computer-assisted navigation systems on clinical performance and longevity needs further investigation in large sample, long-term randomized trials.
authors: Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, 600 Yisan Road, Shanghai 200233, People's Republic of China.
authors: Tao
authors: T
authors: Cheng
authors: Guo-You
authors: GY
authors: Zhang
authors: Xian-Long
authors: XL
authors: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000209:etiology; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function; D025321:Surgery, Computer-Assisted; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult