Clinical impact of component placement in manually instrumented total knee arthroplasty : a systematic review.
Bone Joint J
; 103-B(9): 1449-1456, 2021 Sep.
Article
en En
| MEDLINE
| ID: mdl-34465158
ABSTRACT
AIMS:
The goal of the current systematic review was to assess the impact of implant placement accuracy on outcomes following total knee arthroplasty (TKA).METHODS:
A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using the Ovid Medline, Embase, Cochrane Central, and Web of Science databases in order to assess the impact of the patient-reported outcomes measures (PROMs) and implant placement accuracy on outcomes following TKA. Studies assessing the impact of implant alignment, rotation, size, overhang, or condylar offset were included. Study quality was assessed, evidence was graded (one-star no evidence, two-star limited evidence, three-star moderate evidence, four-star strong evidence), and recommendations were made based on the available evidence.RESULTS:
A total of 49 studies were identified for inclusion. With respect to PROMs, there was two-star evidence in support of mechanical axis alignment (MAA), femorotibial angle (FTA), femoral coronal angle (FCA), tibial coronal angle (TCA), femoral sagittal angle (FSA), femoral rotation, tibial and combined rotation/mismatch, and implant size/overhang or offset on PROMs, and one-star evidence in support of tibial sagittal angle (TSA), impacting PROMs. With respect to survival, there was three- to four-star evidence in support FTA, FCA, TCA, and TSA, moderate evidence in support of femoral rotation, tibial and combined rotation/mismatch, and limited evidence in support of MAA, FSA, and implant size/overhang or offset impacting survival.CONCLUSION:
Overall, there is limited evidence to suggest that PROMs are impacted by the accuracy of implant placement, and malalignment does not appear to be a significant driver of the observed high rates of patient dissatisfaction following TKA. However, FTA, FCA, TCA, TSA, and implant rotation demonstrate a moderate-strong relationship with implant survival. Efforts should be made to improve the accuracy of these parameters in order to improve TKA survival. Cite this article Bone Joint J 2021;103-B(9)1449-1456.Palabras clave
FCA; Implant alignment; Implant overhang; Implant rotation; Implant size; Implant survival; Medline; Patient-reported outcome measures; TSA; Total knee arthroplasty; WOMAC; femoral rotation; knees; patient-reported outcomes measures (PROMs); patient-specific instrumentation; total knee arthroplasty (TKA); valgus
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Artroplastia de Reemplazo de Rodilla
/
Medición de Resultados Informados por el Paciente
/
Prótesis de la Rodilla
Tipo de estudio:
Prognostic_studies
/
Systematic_reviews
Idioma:
En
Revista:
Bone Joint J
Año:
2021
Tipo del documento:
Article