Navigation and robotics improved alignment compared with PSI and conventional instrument, while clinical outcomes were similar in TKA: a network meta-analysis.
Knee Surg Sports Traumatol Arthrosc
; 30(2): 721-733, 2022 Feb.
Article
em En
| MEDLINE
| ID: mdl-33492410
ABSTRACT
PURPOSE:
To achieve the desired alignment more accurately and improve postoperative outcomes, new techniques such as computer navigation (Navigation), patient-specific instruments (PSI) and surgical robots (Robot) are applied in Total Knee Arthroplasty (TKA). This network meta-analysis aims to compare the radiological and clinical outcomes among the above-mentioned techniques and conventional instruments (CON).METHODS:
A PRISMA network meta-analysis was conducted and study protocol was published online at INPLASY (INPLASY202060018). Three databases (PubMed, EMBASE and Cochrane) were searched up to June 1, 2020. Randomised controlled trials (RCTs) comparing any two of the four techniques were included. A Bayesian network meta-analysis was performed focusing on radiological and clinical outcomes. The odds ratio (OR) or mean difference (MD) in various outcomes were calculated, and the interventions were ranked by the surface under the cumulative ranking area (SUCRA) value.RESULTS:
Seventy-three RCTs were included, with a total of 4209 TKAs. Navigation and Robot could significantly reduce the occurrence of malalignment and malposition compared with PSI and CON, and Navigation could obtain higher medium-and-long-term KSS knee scores than CON. Robot had the greatest advantage in achieving the desired alignment accurately, followed by Navigation; Navigation had the greatest advantage in the KSS score.CONCLUSION:
Navigation and Robot did improve the accuracy of alignment compared with PSI and conventional instrument in TKA, but the above four techniques showed no clinical significance in postoperative outcomes. LEVEL OF EVIDENCE I.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Robótica
/
Artroplastia do Joelho
/
Cirurgia Assistida por Computador
Tipo de estudo:
Clinical_trials
/
Guideline
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Knee Surg Sports Traumatol Arthrosc
Assunto da revista:
MEDICINA ESPORTIVA
/
TRAUMATOLOGIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
China