A meta-analysis of the therapeutic effect of total knee replacement after knee arthroscopic surgery.

IF 3 2区医学 Q1 ORTHOPEDICS

Journal of Orthopaedics and Traumatology Pub Date : 2025-05-22 DOI:10.1186/s10195-025-00848-9

Yunwei Xu, Weidong Wang

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引用次数: 0

Abstract

Purpose: To appraise the influence of knee arthroscopic surgery on subsequent total knee arthroplasty (TKA) through meta-analysis.

Methods: A computer search was implemented from the establishment of the database to August 2023 for literature on the influence of knee arthroscopic surgery on the efficacy of subsequent TKA in Web of Science, PubMed, CNKI, Embase, Cochrane Library, Wanfang, and other databases. Quality assessment, literature screening, and data extraction were enforced according to the exclusion and inclusion criteria, and the methodological quality of the involved literature was assessed using the risk-of-bias assessment method recommended by the Cochrane Assistance Network. RevMan 5.4 software was used to conduct a meta-analysis on the postoperative revision rate, periprosthetic infection rate, postoperative stiffness rate, postoperative venous thromboembolism (VTE) incidence rate, reoperation rate, and postoperative knee flexion range of motion after TKA.

Results: Seven documents were finally involved, with a total of 42,642 cases, including 3405 cases in the knee arthroscopy group and 39,237 cases in the non-knee arthroscopy group. Meta-analysis results show that in the revision rate [95% confidence interval (CI) 0.97, 44.82] and reoperation rate [95% CI 1.66, 4.23] after TKA between the knee arthroscopy surgery group and the non-knee arthroscopy surgery group, there were statistically significant differences in postoperative stiffness rate [95% CI 0.86, 10.84] and periprosthetic infection rate [95% CI 0.86, 2.07], while in postoperative VTE incidence [95% CI 0.83, 1.35] and in postoperative knee flexion range of motion [95% CI -0.35, 0.10] there was no statistically significant difference.

Conclusions: Knee arthroscopic surgery hurts subsequent TKA surgery. Previous arthroscopic surgery increased the risk of postoperative stiffness, revision, periprosthetic infection, and reoperation after TKA, but there was no significant difference in the incidence of VTE and knee flexion range of motion after surgery.

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膝关节镜手术后全膝关节置换术治疗效果的meta分析。

目的：通过meta分析，评价膝关节镜手术对后续全膝关节置换术（TKA）的影响。方法：计算机检索Web of Science、PubMed、CNKI、Embase、Cochrane Library、万方等数据库中关于膝关节镜手术对后续TKA疗效影响的文献，自数据库建立至2023年8月。根据排除标准和纳入标准进行质量评估、文献筛选和数据提取，采用Cochrane辅助网络推荐的偏倚风险评估方法评估相关文献的方法学质量。采用RevMan 5.4软件对TKA术后翻修率、假体周围感染率、术后僵硬率、术后静脉血栓栓塞（venous thromboembolism， VTE）发生率、再手术率、术后膝关节屈曲活动度进行meta分析。结果：最终纳入7篇文献，共42642例，其中膝关节镜组3405例，非膝关节镜组39237例。meta分析结果显示，膝关节镜手术组与非膝关节镜手术组TKA术后翻修率[95%可信区间（CI） 0.97, 44.82]、再手术率[95% CI 1.66, 4.23]，术后僵硬率[95% CI 0.86, 10.84]、假体周围感染率[95% CI 0.86, 2.07]差异有统计学意义；而术后静脉血栓栓塞发生率[95% CI 0.83, 1.35]和术后膝关节屈曲活动范围[95% CI -0.35, 0.10]差异无统计学意义。结论：膝关节镜手术对TKA术后有损伤。既往关节镜手术增加了术后僵硬、翻修、假体周围感染和TKA后再手术的风险，但术后VTE发生率和膝关节屈曲活动范围无显著差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Orthopaedics and Traumatology Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

审稿时长

13 weeks

期刊介绍： The Journal of Orthopaedics and Traumatology, the official open access peer-reviewed journal of the Italian Society of Orthopaedics and Traumatology, publishes original papers reporting basic or clinical research in the field of orthopaedic and traumatologic surgery, as well as systematic reviews, brief communications, case reports and letters to the Editor. Narrative instructional reviews and commentaries to original articles may be commissioned by Editors from eminent colleagues. The Journal of Orthopaedics and Traumatology aims to be an international forum for the communication and exchange of ideas concerning the various aspects of orthopaedics and musculoskeletal trauma.