Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Arthroscopy. 2011 Jan;27(1):97-100. doi: 10.1016/j.arthro.2010.05.012. Epub 2010 Oct 15.
The use of computer navigation systems in anterior cruciate ligament (ACL) has been the subject of debate. However, there is a lack of systematic review to analyze the radiographic outcomes after computer-navigated ACL reconstruction.
We searched, in duplicate, Medline, Embase, and Web of Science databases for randomized controlled trials (RCTs)/quasi-RCTs comparing conventional versus computer-navigated ACL reconstruction. Two reviewers independently extracted the data. Radiographic outcomes reported in a majority of included trials were meta-analyzed using the Mantel-Haenszel test statistic.
After applying our eligibility criteria, we had 5 trials for systematic review and data synthesis. There was no evidence of statistical heterogeneity between all included studies. Both navigated and conventional ACL reconstructions placed the tibial tunnel in acceptable positions. The risk of notch impingement was reduced in the navigated group in comparison with the conventional group.
A computer navigation systems may reduce variation from optimal graft alignment and notch impingement. However, there is a need for further high-quality studies with long-term follow-up, so as to prove the clinical significance of these findings.
Level II, systematic review of randomized controlled trials.
计算机导航系统在前交叉韧带（ACL）重建中的应用一直存在争议。然而，缺乏系统评价来分析计算机导航 ACL 重建后的影像学结果。
我们对 Medline、Embase 和 Web of Science 数据库进行了重复检索，以查找比较传统与计算机导航 ACL 重建的随机对照试验（RCT）/准 RCT。两位评审员独立提取数据。使用 Mantel-Haenszel 检验统计量对大多数纳入试验报告的影像学结果进行荟萃分析。
应用入选标准后，我们有 5 项试验进行系统评价和数据综合。所有纳入研究之间均无统计学异质性。导航组和传统组均将胫骨隧道置于可接受的位置。与传统组相比，导航组的切迹撞击风险降低。
计算机导航系统可能减少从最佳移植物对线和切迹撞击的偏差。然而，需要进一步进行高质量、长期随访的研究，以证明这些发现的临床意义。
II 级，随机对照试验的系统评价。
