In their meta-analysis of the effectiveness of navigated total knee
replacement, Bauwens et al. found that navigation was associated with
favorable results in terms of several radiographic parameters. The data were
insufficient to evaluate effects on complication rates or functional outcomes.
The article stimulated the above letter from Mason et al. and a letter from
Gregori and Holt13,
which prompted additional letters of clarification from Bauwens et al.Caught in the crossfire, readers might well ask why a meta-analysis led to
such editorial dueling. Of note, controversy over meta-analysis is
The debates stem in part from the methodological complexity of meta-analysis,
a powerful but challenging analytic technique that permits pooling of
estimates across studies. We will discuss a few of the many methodological
complexities of meta-analysis to put the correspondence about navigated total
knee replacement in perspective.