The Clinical Outcome of Computer-Navigated Compared with Conventional Knee Arthroplasty in the Same Patients
Bibliographic record
Abstract
BACKGROUND: The available comparative studies of computer navigation-assisted and conventional knee arthroplasties have short-term follow-up periods. Therefore, the clinical benefits after long-term follow-up are not clear. The purposes of the current long-term study were to compare clinical outcomes, alignment of the knee components, prevalence of aseptic loosening of the components, implant survival, and complications of total knee arthroplasties performed with and without computer navigation. METHODS: We prospectively compared the results of 162 consecutive patients (324 knees) with osteoarthritis. These patients had computer-navigated knee arthroplasty in 1 knee and knee arthroplasty without computer navigation in the other. Nine men and 153 women were enrolled in the study. At the time of the index arthroplasty, the mean age of these patients was 68.1 years (range, 49 to 81 years). The mean duration of follow-up was 12.3 years (range, 12 to 13 years). Clinical and radiographic follow-up examinations of the patients were performed at 3 months, 1 year after the operation, and every 2 or 3 years thereafter. RESULTS: The Knee Society knee score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and range of knee motion were not significantly different between the groups preoperatively or at 12.3 years of follow-up. Patient satisfaction at the final follow-up was not significantly different between the groups. There were no significant differences between the groups with respect to the position and loosening of the components at 12.3 years of follow-up. The Kaplan-Meier survivorship, with revision or loosening as the end point, was 100% (95% confidence interval [CI], 94% to 100%) at 12.3 years in both groups. The prevalence of anterior femoral notching was higher in the computer-navigated knee arthroplasty group (5%) than in the conventional knee arthroplasty group (0.6%). CONCLUSIONS: Clinical function, position, and survivorship of the components were similar between the groups. The only effect of navigation was a negative one, anterior femoral notching. However, comparison of bilateral total knee arthroplasties may dampen the differentiation regarding pain outcomes. Further, the findings of this study are specific to a single navigation and total knee system. LEVEL OF EVIDENCE: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 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) | 0.001 | 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 source (direct Gemma or distilled Codex), 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".