Improving surgical precision when targeting the wrong goal should not produce better results ΠJBJS eLetters

You recently published an article by Roberts et al.: Outcomes of Computer-Assisted Surgery Compared with Conventional Instrumentation in 19,221 Total Knee Arthroplasties (1). Roberts et al. analyzed the revision rates and functional data in 19,221 TKAs from the New Zealand Joint Registry by comparing 2 cohorts of patients: those performed by routine CAS surgeons and those performed by routine conventional surgeons. The study proved no difference in survivorship or functional outcome scores to support any benefit for using CAS for TKA. A note by Stefano A. Bini was also released by your journal: Rethinking the Value of Computer-Assisted Surgery (2). In this commentary, the author wrote: “there is a general agreement that CAS (1) increases alignment accuracy and (2) does not produce worse outcomes. One reason may be that there simply is not much room for improvement when the reported results associated with traditional instrumentation are already excellent.”