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Letters to the Editor   |    
Navigated Total Knee Replacement. A Meta-Analysis
Alberto Gregori, FRCS; Graeme Holt, MRCS
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. A commercial entity (Biomet and BBraun) paid or directed in any one year, or agreed to pay or direct, benefits in excess of $10,000 to a research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2007 Aug 01;89(8):1867-1867
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To The Editor:In the recent study "Navigated Total Knee Replacement. A Meta-Analysis" (2007;89: 261-9), Bauwens et al. concluded that "navigated knee replacement provides few advantages...on the basis of radiographic end points." However, our analysis of this paper suggests that this conclusion is invalid.While meta-analysis of randomized controlled trials represents the gold standard in validation of interventions, overcoming the reduced statistical power of small sample sizes, it cannot compensate for poor scientific methodology in the analyzed papers. The authors included not only randomized trials but also quasi-randomized controlled trials, nonrandomized cohort studies, studies with historical cohorts, and studies investigating the outcome of computed tomography or image-free navigation systems for both unicompartmental and total knee arthroplasty.
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