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Letters to the Editor   |    
D. Stengel and K. Bauwens reply:
Dirk Stengel, MD, PhD, MSc; Kai Bauwens, MD
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These letters originally appeared, in slightly different form, on jbjs.org. They are still available on the web site in conjunction with the article to which they refer.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2007 Aug 01;89(8):1867-1868
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Extract

We read with great interest the comments by Alberto Gregori and Graeme Holt regarding our meta-analysis. We believe all of the issues they raise were clearly addressed in the printed article and the electronic appendix, but we will be happy to respond to their letter in a point-by-point fashion.First, we do not agree that the conclusion of the abstract conflicts with current best evidence. Most trials focused on alignment and not on function, quality of life, or cost. We believe that all would agree that higher precision in restoring the physiological limb axis is an advantage of navigated total knee replacement over conventional total knee replacement, but patient-centered and health-economic values have more weight in clinical and political decision-making. In the Discussion, we stressed the need for high-quality trials aimed at investigating clinically relevant outcomes.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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