Inconsistencies between navigation data and radiographs in total knee arthroplasty are system-dependent and affect coronal alignment
Bibliographic record
Abstract
BACKGROUND: Few studies have compared the effect of different computer navigation systems on postoperative alignment in patients who have had total knee arthroplasty (TKA). We examined 2 computed tomography (CT)-free computer navigation systems by comparing the accuracy of intraoperative measurements to postoperative alignment. METHODS: Patients underwent unilateral TKA performed by a single surgeon using 1 of 2 CT-free navigation systems. We compared final intraoperative tibial and femoral coronal angles and mechanical axis with the same angles measured on standing postoperative radiographs. RESULTS: Groups of 31 and 50 patients underwent TKA with the 2 systems, respectively. We noted a significant difference in the coronal tibial implant angle (1.29º ± 1.35º) and in the mechanical axis (1.59º ± 2.36º) for one navigation system (both p < 0.001), while only the coronal tibial implant angle showed a significant difference (1.17º ± 1.65º, p < 0.001) for the second system. The number of radiographic outliers also significantly differed. A significantly higher proportion (32%; p < 0.01) of patients in the second cohort exhibited unacceptable malalignment compared with the first cohort (24%). CONCLUSION: Navigation systems for TKA continue to increase in sophistication and popularity. Owing to the significant difference in the proportion of alignment outliers in the 2 navigation systems tested in this study, orthopedic surgeons should not consider all TKA navigation systems equivalent. Additional investigations are needed to compare the accuracy of a variety of CT-free and CT-based navigation systems and to confirm our finding that accuracy is system-dependent.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".