The efficacy and safety of patient-specific instrumentation in primary total knee replacement: a systematic review and meta-analysis.

IF 2.9 3区医学 Q3 ENGINEERING, BIOMEDICAL

Expert Review of Medical Devices Pub Date : 2023-03-01 DOI:10.1080/17434440.2023.2177152

J H Hinloopen, R Puijk, P A Nolte, J W Schoones, R de Ridder, B G Pijls

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引用次数: 1

Abstract

Introduction: Patient-specific instrumentation (PSI) for primary total knee arthroplasty (TKA) surgery has been shown to increase accuracy of component positioning. However, it is unclear whether this also translates to actual benefits for patients in terms of better outcomes (efficacy) or less complications such as revisions (safety). We therefore systematically reviewed the literature to determine the efficacy and safety of PSI in primary TKA.

Methods: Randomized controlled trials comparing PSI to non-PSI in primary TKA were included. A random effects model was used with meta-regression in case of heterogeneity.

Results: Forty-three studies were included with a total of 1816 TKA in the PSI group and 1887 TKA in the control group. There were no clinically relevant differences between the PSI-group and non-PSI group regarding all outcomes. There was considerable heterogeneity: meta-regression analyses showed that the year the study was published was an important effect modifier. Early publications tended to show a positive effect for PSI compared to non-PSI TKA, whereas later studies found the opposite.

Conclusion: Based on evidence of moderate certainty, our study suggested that there were no clinically relevant differences in efficacy and safety between patients treated with PSI TKA and patients treated with non-PSI TKA.

查看原文本刊更多论文

原发性全膝关节置换术中患者特异性内固定的有效性和安全性:一项系统回顾和荟萃分析。

简介:原发性全膝关节置换术(TKA)手术中患者特异性内固定(PSI)已被证明可以提高部件定位的准确性。然而，目前尚不清楚这是否也转化为患者在更好的结果(疗效)或更少的并发症(如修正(安全性)方面的实际益处。因此，我们系统地回顾了文献，以确定PSI在原发性TKA中的有效性和安全性。方法:采用随机对照试验，比较原发性TKA的PSI和非PSI。在异质性的情况下，采用随机效应模型和元回归。结果:共纳入43项研究，PSI组共1816例TKA，对照组共1887例TKA。psi组和非psi组在所有结果方面没有临床相关差异。存在相当大的异质性:元回归分析显示，研究发表的年份是一个重要的影响修饰因子。与非PSI TKA相比，早期的出版物倾向于显示PSI的积极作用，而后来的研究发现相反。结论:基于中等确定性的证据，我们的研究表明，PSI TKA患者与非PSI TKA患者在疗效和安全性方面没有临床相关差异。

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

Expert Review of Medical Devices 医学-工程：生物医学

CiteScore

5.90

自引率

3.20%

发文量

审稿时长

6-12 weeks

期刊介绍： The journal serves the device research community by providing a comprehensive body of high-quality information from leading experts, all subject to rigorous peer review. The Expert Review format is specially structured to optimize the value of the information to reader. Comprehensive coverage by each author in a key area of research or clinical practice is augmented by the following sections: Expert commentary - a personal view on the most effective or promising strategies Five-year view - a clear perspective of future prospects within a realistic timescale Key issues - an executive summary cutting to the author''s most critical points In addition to the Review program, each issue also features Medical Device Profiles - objective assessments of specific devices in development or clinical use to help inform clinical practice. There are also Perspectives - overviews highlighting areas of current debate and controversy, together with reports from the conference scene and invited Editorials.