A Meta - Analysis Comparison of Navigated Versus Conventional Total Knee Arthroplasty

The prevalence of malalignment after total knee arthroplasty (TKA) can be as high as 25% at some centers (Knee. 2003 Mar;10[1]:55-60, and J Arthroplasty. 2001 Aug;16[5]:635-40). Typically, one of the goals is restoration of the mechanical axis to £3° of varus or valgus. One potential way to more accurately restore mechanical alignment and reduce outliers is through a custom-fit technique. This involves custom-made tibial and femoral cutting guides, which are blocks that are constructed from a three-dimensional model of the arthritic knee. Other potential advantages of this technique are that it may decrease operating time, decrease blood loss, and lower the risk of fat embolism since intramedullary rods are not needed (Orthopedics. 2008 Sep;31[9]:927-30, Int Orthop. 2009 Dec;33[6]:1571-5, and J Arthroplasty. 2008 Jan;23[1]:26-9). Because there have been only a few studies on this topic, Bali et al. reviewed their initial experience with twentynine custom-fit TKAs to see how well this technique restored the mechanical axis and whether it had any advantages concerning blood loss and the duration of surgery.