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E. Carlos Rodríguez-Merchán Department of Orthopaedic Surgery, ‘La Paz’ University Hospital-IdiPAZ, Madrid, Spain

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. Technological assistance for precisely implanting TKA (computer-assisted navigation system – CAS, Robotics, patient-specific instrumentation – PSI) has not been a game-changer for TKA outcomes. This means that technical errors in component positioning may not

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Nicholas D. Clement Department of Orthopaedics, Freeman Hospital, Newcastle, UK
Department of Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
South West of London Orthopaedic Elective Centre, Epsom, UK

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Marwan Al-Zibari South West of London Orthopaedic Elective Centre, Epsom, UK

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Irrum Afzal South West of London Orthopaedic Elective Centre, Epsom, UK

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David J. Deehan Department of Orthopaedics, Freeman Hospital, Newcastle, UK

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Deiary Kader South West of London Orthopaedic Elective Centre, Epsom, UK

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implant position is fair, (5) there is poor reporting of implant type/design, and (6) there were no data reporting patient expectations or cost-economic analysis and there were no randomized controlled trials. A limitation of this systematic review was

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Michele Vasso Concordia Hospital for Special Surgery, Rome, Italy

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Alexander Antoniadis Bürgerspital Solothurn, Switzerland

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Naeder Helmy Bürgerspital Solothurn, Switzerland

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selection, optimal implant positioning might be crucial to reduce the potential for surgical errors. With the use of computer navigation (CAS), it has been shown that the position of the implant can be improved. 63 A study using patient

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E. Carlos Rodríguez-Merchán Department of Orthopaedic Surgery, “La Paz” University Hospital-IdiPaz, Madrid, Spain

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the patients was 79 years (75 to 86); the minimum follow-up was 5 years (mean 7.3 years (5 to 10 )). Patients were evaluated clinically (Knee Society score) and radiographically (position of prosthetic components, signs of loosening, bone loss). At a

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David Barrett School of Engineering Science, University of Southampton, United Kingdom
Instituto Clinico Citta Studi, Milan, Italy

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Angela Brivio Instituto Clinico Citta Studi, Milan, Italy
King Edward VII Hospital, London, UK

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Introduction There is no doubt that total knee replacement has become a successful, reliable and life-changing intervention for many thousands of patients, with established survival figures above 95% over 15 years ( 1 ). More recently, however

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Emmanuel Thienpont University Hospital Saint Luc, Brussels, Belgium

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anatomy, 2 primarily by re-establishing the correct joint-line position. 15 Between 50% and 80% of rTKA patients have an elevated joint line, 16 , 17 and this is associated with lower clinical and functional outcomes such as anterior knee

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Andrea Ferrera Department of Orthopaedic and Traumatology, Orthopaedic and Trauma Centre, Turin, Italy

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Jacques Menetrey Centre de Médecine du Sport et de l’Exercice (CMSE), Swiss Olympic Medical Center, Hirslanden Clinique La Colline, Geneva, Switzerland
Division of Orthopaedic Surgery, University Hospital of Geneva, Geneva, Switzerland

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the knee. The growth of arthroplasty surgery and the subsequent technologic development of new, reliable and better performing prostheses, mostly implanted in elderly patients with low function, led to a progressive loss of interest for osteotomies

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Sohail Nisar Leeds Institute of Rheumatic and Musculoskeletal Medicine, UK
Academic Department of Trauma and Orthopaedics, LGI, University of Leeds, Leeds, UK
Leeds Teaching Hospitals Trust, UK

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Jeya Palan Leeds Teaching Hospitals Trust, UK

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Charles Rivière MSK Lab - Imperial College London, White City Campus, London, UK
The Lister Hospital, Chelsea Bridge, London, UK
Centre de l’Arthrose - Clinique du Sport, Bordeaux-Mérignac, France

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Mark Emerton Leeds Teaching Hospitals Trust, UK

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Hemant Pandit Leeds Institute of Rheumatic and Musculoskeletal Medicine, UK
Leeds Teaching Hospitals Trust, UK

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mobility. Up to 20% of patients annually (20,000 patients) who have a TKR are not satisfied with the outcome. 2 , 3 A significant proportion complain about restricted knee flexion, residual pain and limitations in performing day-to-day activities such

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Kara McConaghy Case Western Reserve University School of Medicine, Cleveland, Ohio, USA

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Tabitha Derr Implant Research Core, School of Biomedical Engineering, Science, and Health Systems, Drexel University, Philadelphia, Pennsylvania, USA

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Robert M. Molloy Cleveland Clinic, Department of Orthopedic Surgery, Cleveland, Ohio, USA

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Alison K. Klika Cleveland Clinic, Department of Orthopedic Surgery, Cleveland, Ohio, USA

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Steven Kurtz Implant Research Core, School of Biomedical Engineering, Science, and Health Systems, Drexel University, Philadelphia, Pennsylvania, USA
Exponent, Philadelphia, Pennsylvania, USA

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Nicolas S. Piuzzi Cleveland Clinic, Department of Orthopedic Surgery, Cleveland, Ohio, USA

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patient outcomes, as long as patellar resection symmetry is ultimately achieved. Component alignment Appropriate component alignment and positioning is critical to accurate patellar tracking in TKA. 54 If there is maltracking of the patella, TKA

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Francesco Benazzo Sezione di Chirurgia Protesica ad Indirizzo Robotico – Unità di Traumatologia dello Sport, U.O Ortopedia e Traumatologia Fondazione Poliambulanza, Brescia, Lombardy, Italy
Università degli Studi di Pavia, Pavia, Lombardy, Italy

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Loris Perticarini Sezione di Chirurgia Protesica ad Indirizzo Robotico – Unità di Traumatologia dello Sport, U.O Ortopedia e Traumatologia Fondazione Poliambulanza, Brescia, Lombardy, Italy

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Eugenio Jannelli Clinica Ortopedica e Traumatologia, Fondazione IRCCS Policlinico San Matteo – Pavia, Lombardy, Italy

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Alessandro Ivone Clinica Ortopedica e Traumatologia, Fondazione IRCCS Policlinico San Matteo – Pavia, Lombardy, Italy

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Matteo Ghiara Clinica Ortopedica e Traumatologia, Fondazione IRCCS Policlinico San Matteo – Pavia, Lombardy, Italy

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Stefano Marco Paolo Rossi Sezione di Chirurgia Protesica ad Indirizzo Robotico – Unità di Traumatologia dello Sport, U.O Ortopedia e Traumatologia Fondazione Poliambulanza, Brescia, Lombardy, Italy

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(MRI) is performed, the quality and thickness of the patella’s articular cartilage at the time of knee arthroplasty are unpredictable as well as how long it would last especially in patients with different age, level of activity, body mass index (BMI

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