Gap balancing versus measured resection for primary total knee arthroplasty: a meta-analysis study.


Journal

Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043

Informations de publication

Date de publication:
Sep 2020
Historique:
received: 24 02 2020
pubmed: 16 5 2020
medline: 16 12 2020
entrez: 16 5 2020
Statut: ppublish

Résumé

To achieve the most desirable post-operative results, operation techniques and procedures for total knee arthroplasty (TKA) are highly standardized. However, debates persist whether patients having undergone a gap balancing technique (GB) perform better than those having undergone measured resection (MR) technique. Therefore, a meta-analysis study was conducted to investigate advantages of GB compared to the MR. The focus of the present study was on clinical and functional scores, radiological measurements and further complications. The present meta-analysis was conducted according to the PRISMA checklist. In November 2019, literature search was performed. All clinical studies comparing measured resection technique versus gap balancing technique for primary total knee arthroplasty were considered for inclusion. Only articles reporting quantitative data under the outcomes of interest were eligible for inclusion. The methodological quality assessment and statistical analyses were performed through the Review Manager Software version 5.3 (The Cochrane Collaboration, Copenhagen). Data from 25 clinical trials (2971 procedures) were collected. Patient baseline demonstrated a good comparability. No difference among the two cohorts was found in terms of SF-12 Mental and Physical, ROM, KSS, KSS Function, OKS, WOMAC. No difference was found in the alignment of mechanical axis and femoral rotation. During the knee motion, no difference was found between the medial and lateral gaps among the two techniques. The GB showed a significant elevated joint line (P < 0.0001), along with a longer duration of the operating time (P = 0.001). No differences were found in terms of revision surgery, aseptic loosening or prosthetic infections. GB and MR achieve similar outcomes for TKA. In the GB group, a proximalisation of the joint line and extended operating time was detected. Regarding the additional outcomes of interest, the present analysis showed comparability between both groups, MR and GB.

Identifiants

pubmed: 32409905
doi: 10.1007/s00402-020-03478-4
pii: 10.1007/s00402-020-03478-4
doi:

Types de publication

Journal Article Meta-Analysis

Langues

eng

Sous-ensembles de citation

IM

Pagination

1245-1253

Références

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Auteurs

Filippo Migliorini (F)

Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Pauwelsstraße, 30, 52074, Aachen, Germany. migliorini.md@gmail.com.

Jörg Eschweiler (J)

Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Pauwelsstraße, 30, 52074, Aachen, Germany.

Yasser El Mansy (YE)

Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Pauwelsstraße, 30, 52074, Aachen, Germany.
Department of Orthopaedics, University of Alexandria, Alexandria, Egypt.

Valentin Quack (V)

Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Pauwelsstraße, 30, 52074, Aachen, Germany.

Hanno Schenker (H)

Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Pauwelsstraße, 30, 52074, Aachen, Germany.

Markus Tingart (M)

Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Pauwelsstraße, 30, 52074, Aachen, Germany.

Arne Driessen (A)

Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Pauwelsstraße, 30, 52074, Aachen, Germany.

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