Is computer-assisted total knee arthroplasty currently of no proven clinical benefit : a systematic review?
The findings in reports of navigated TKA should be interpreted with caution. There are few short- and medium- and no long-term studies demonstrating improved clinical outcomes using navigated TKA. Despite substantial research, contradictory findings coupled with reservations about the cost and efficacy of the technology have contributed to the failure of computer navigation to become the accepted standard in TKA. Longer-term studies demonstrating improved function, lower revision rates, and acceptable costs are required before navigated TKA may be widely adopted. In the future, with improvements in study design, methodology, imaging, navigation technology, newer functional outcome tools, and longer-term followup studies, we suspect that navigated TKA may demonstrate yet unrecognized benefits.
Brain metastases are uncommon at the time of initial diagnosis of metastatic RMS arising outside the head and neck region, and the majority of abnormalities detected on head CT or MRI scans are evident clinically or on other imaging studies. Patients with clinical findings suggesting intracranial pathology and those with paraspinal tumors may benefit from brain imaging, but cost savings may be realized by foregoing imaging in patients without these features.