{"title":"Kinematic and mechanical alignments in total knee arthroplasty: A meta-analysis with ≥1-year follow-up","authors":"","doi":"10.1016/j.jos.2023.08.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Kinematic and mechanical alignment outcomes in total knee arthroplasty remain controversial. This study compared the clinical and radiological outcomes of total knee arthroplasty using kinematic and mechanical alignments.</p></div><div><h3>Methods</h3><p>We systematically searched PubMed, EMBASE, Web of Science, and Cochrane Library databases for randomized controlled trials<span> and cohort studies published before November 2022. The data of interest were extracted and analyzed using Review Manager V.5.4.</span></p></div><div><h3>Results</h3><p>Nineteen randomized controlled trials and cohort studies involving 880 kinematic alignment total knee arthroplasties and 965 mechanical alignment total knee arthroplasties were included. In this meta-analysis, the kinematic alignment group achieved better knee joint function scores, including the Oxford Knee Score<span><span><span>, Knee Injury and Osteoarthritis Outcome Score, and </span>Knee Society Score, and better flexion angles. No statistical differences were detected in the </span>Western Ontario and McMaster Universities Osteoarthritis Index<span>, extension angle, Forgotten Joint Score, European Quality of Life five-dimension measure, hip–knee–ankle angle, or complications between the kinematic and mechanical alignment groups.</span></span></p></div><div><h3>Conclusion</h3><p>This meta-analysis indicated that kinematic alignment total knee arthroplasty provides clinical benefits in terms of the Oxford Knee Score, Knee Injury and Osteoarthritis Outcome Score, Knee Society Score (knee), Knee Society Score (function), and better flexion angles. In addition, kinematic alignment total knee arthroplasty led to similar clinical outcomes as mechanical alignment total knee arthroplasty without increasing complications.</p></div><div><h3>Systematic review registration</h3><p><span><span>http://www.crd.york.ac.uk/PROSPERO/CRD42022373227</span><svg><path></path></svg></span>.</p></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 5","pages":"Pages 1226-1234"},"PeriodicalIF":1.5000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic Science","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0949265823002105","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Kinematic and mechanical alignment outcomes in total knee arthroplasty remain controversial. This study compared the clinical and radiological outcomes of total knee arthroplasty using kinematic and mechanical alignments.
Methods
We systematically searched PubMed, EMBASE, Web of Science, and Cochrane Library databases for randomized controlled trials and cohort studies published before November 2022. The data of interest were extracted and analyzed using Review Manager V.5.4.
Results
Nineteen randomized controlled trials and cohort studies involving 880 kinematic alignment total knee arthroplasties and 965 mechanical alignment total knee arthroplasties were included. In this meta-analysis, the kinematic alignment group achieved better knee joint function scores, including the Oxford Knee Score, Knee Injury and Osteoarthritis Outcome Score, and Knee Society Score, and better flexion angles. No statistical differences were detected in the Western Ontario and McMaster Universities Osteoarthritis Index, extension angle, Forgotten Joint Score, European Quality of Life five-dimension measure, hip–knee–ankle angle, or complications between the kinematic and mechanical alignment groups.
Conclusion
This meta-analysis indicated that kinematic alignment total knee arthroplasty provides clinical benefits in terms of the Oxford Knee Score, Knee Injury and Osteoarthritis Outcome Score, Knee Society Score (knee), Knee Society Score (function), and better flexion angles. In addition, kinematic alignment total knee arthroplasty led to similar clinical outcomes as mechanical alignment total knee arthroplasty without increasing complications.
背景全膝关节置换术中的运动学对位和机械对位结果仍存在争议。本研究比较了使用运动学对位和机械对位的全膝关节置换术的临床和放射学结果。方法我们系统地检索了PubMed、EMBASE、Web of Science和Cochrane Library数据库中2022年11月之前发表的随机对照试验和队列研究。结果纳入了19项随机对照试验和队列研究,涉及880例运动学配位全膝关节置换术和965例机械配位全膝关节置换术。在这项荟萃分析中,运动学对位组获得了更好的膝关节功能评分,包括牛津膝关节评分、膝关节损伤和骨关节炎结果评分、膝关节社会评分,以及更好的屈曲角度。在西安大略和麦克马斯特大学骨关节炎指数、伸展角度、遗忘关节评分、欧洲生活质量五维测量、髋关节-膝关节-踝关节角度或并发症方面,运动对齐组和机械对齐组之间未发现统计学差异。结论这项荟萃分析表明,在牛津膝关节评分、膝关节损伤和骨关节炎结果评分、膝关节社会评分(膝关节)、膝关节社会评分(功能)和更好的屈曲角度方面,运动学对位全膝关节置换术具有临床优势。此外,运动定位全膝关节置换术的临床效果与机械定位全膝关节置换术相似,且并发症不会增加。系统综述注册http://www.crd.york.ac.uk/PROSPERO/CRD42022373227。
期刊介绍:
The Journal of Orthopaedic Science is the official peer-reviewed journal of the Japanese Orthopaedic Association. The journal publishes the latest researches and topical debates in all fields of clinical and experimental orthopaedics, including musculoskeletal medicine, sports medicine, locomotive syndrome, trauma, paediatrics, oncology and biomaterials, as well as basic researches.