Does computer navigation system really improve early clinical outcomes after anterior cruciate ligament reconstruction? A meta-analysis and systematic review of randomized controlled trials

Cheng, Tao; Zhang, Guo-You; Zhang, Xian-Long

doi:10.1016/j.knee.2011.02.011

« Previous Next »The Knee
Volume 19, Issue 2 , Pages 73-77, March 2012

Does computer navigation system really improve early clinical outcomes after anterior cruciate ligament reconstruction? A meta-analysis and systematic review of randomized controlled trials

Tao Cheng
- 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
- These authors contributed equally to this work.
Guo-You Zhang
- Department of Hand and Plastic Surgery, Second Affiliated Hospital, Wenzhou Medical College, 109 Xueyuan West Road, Wenzhou 325027, Zhejiang Province, People's Republic of China
- Department of Dermatology, Allergology and Venerology, University Hospital Schleswig-Holstein, University of Lübeck, 160 Ratzeburger Allee, Lübeck 23538, Germany
- These authors contributed equally to this work.
Xian-Long Zhang
- 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
- Corresponding author. Tel.: +86 21 64369181.

Received 2 September 2010; received in revised form 11 February 2011; accepted 23 February 2011. published online 04 April 2011.

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.