title: Computer navigation in total hip arthroplasty: a meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  Traditional operation frequently depends on experience of doctors and anatomic landmark visual observation, which often leads to deviation in acetabular prosthesis implantation. Computer navigation technique greatly improves accuracy of prosthesis implantation. The present meta-analysis aimed at assessing the accuracy and clinical significance of computer navigation for acetabular implantation.
  
  
  METHODS
  All studies published through March 2013 were systematically searched from PubMed, EMBnse, Science Direct, Cechrane library and other databases. Relevant journals or conference proceedings were searched manually. Only randomized controlled trials (RCTs) were included. Two independent reviewers identified and assessed the literature. Mean difference (MD) and Odds ratio (OR) of radiologic and clinical outcomes were pooled throughout the study between navigated and conventional THA. The meta-analysis was conducted by RevMan 5.1 software.
  
  
  RESULTS
  Thirteen studies were included in the review, with a total sample size of 1071 hips. Statistically significant differences were observed between navigated and conventional groups in the number of acetabular cups implanted beyond the safe zone [OR = 0.13, 95% confidence interval (CI) (0.08-0.22); P < 0.00001], operative time [MD = 19.87 min, 95% CI (14.04-24.35); P < 0.00001] and leg length discrepancy [MD = -4.16 mm, 95% CI (-7.74 to -1.48); P = 0.004]. No significant differences in cup inclination, anteversion, incidence of postoperative dislocation or deep vein thrombosis were found.
  
  
  CONCLUSIONS
  The present meta-analysis indicated that the use of computer navigation in patients undergoing THA improves the precision of acetabular cup placement by decreasing the number of outliers, and decreases leg length discrepancy. More high quality RCTs are required to further confirm our results.
authors.affiliation: General Hospital of Tianjin Medical University, Department of Orthopedics, Tianjin 300052, PR China.
authors.forename: Ke
authors.initials: K
authors.lastname: Xu
authors.affiliation: Tianjin Hospital, Department of Rehabilitation, Tianjin 300211, PR China.
authors.forename: Yao-min
authors.initials: YM
authors.lastname: Li
authors.affiliation: Tianjin Hospital, Department of Orthopedics, Tianjin 300052, PR China.
authors.forename: Hua-feng
authors.initials: HF
authors.lastname: Zhang
authors.affiliation: General Hospital of Tianjin Medical University, Department of Orthopedics, Tianjin 300052, PR China.
authors.forename: Chen-guang
authors.initials: CG
authors.lastname: Wang
authors.affiliation: General Hospital of Tianjin Medical University, Department of Orthopedics, Tianjin 300052, PR China.
authors.forename: Yun-qiang
authors.initials: YQ
authors.lastname: Xu
authors.affiliation: General Hospital of Tianjin Medical University, Department of Orthopedics, Tianjin 300052, PR China; Tianjin Medical University, Immunology Department, Tianjin 300070, PR China. Electronic address: hansontijmu@gmail.com.
authors.forename: Zhi-jun
authors.initials: ZJ
authors.lastname: Li
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D011183:Postoperative Complications; D016032:Randomized Controlled Trials as Topic; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D016896:Treatment Outcome
keywords: Arthroplasty; Computer; Hip; Meta-analysis; Navigation