Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria.
Medical University of Innsbruck, Innsbruck, Austria.
Knee Surg Sports Traumatol Arthrosc. 2018 Sep;26(9):2809-2816. doi: 10.1007/s00167-017-4692-6. Epub 2017 Aug 24.
The study aim was to assess the outcome of patellofemoral arthroplasty (PFA), paying particular interest to 'revisions for any reason'. The hypothesis was that there is a superior outcome of PFA reported in dependent clinical studies in contrast to independent clinical literature and that there is a superior outcome of 'trochlear-cutting' PFA in comparison with 'first-generation trochlear-resurfacing' implants.
Studies on PFA from its market introduction in 1955 onwards were systematically reviewed. The revision rate, which was calculated as 'revisions per 100 component years (CY)', was evaluated in 45 studies published in indexed, peer-reviewed international scientific journals. In addition, 'first-generation trochlear-resurfacing' and 'trochlear-cutting' implants as well as dependent and independent clinical literature were analysed. Furthermore, the data of three arthroplasty registers were analysed.
A total of 15,306 PFA were included consisting of 2266 cases in worldwide literature data and of 13,040 cases in register data. 2.22 revisions per 100 CY were observed in worldwide literature data, which corresponds to a revision rate of 22.2% after 10 years. Revision rates between 18.9 and 27% after 10 years were shown by the included three national joint registers. In the group analyses no significant differences were detected.
This meta-analysis did not reveal significant differences in the comparison between developer over independent publications and between 'first-generation-resurfacing' over 'trochlear-cutting' implants. In conclusion the data of developer publications do not seem to be biased. 'Trochlear-cutting' devices of PFA had slightly superior outcomes, but that benefit was not statistically significant. Nevertheless, we would recommend 'trochlear-cutting' devices for further use in PFA.
Meta-analysis of Level IV case series.
本研究旨在评估髌股关节置换术（patellofemoral arthroplasty，PFA）的疗效，特别关注“任何原因的翻修”。假设是，与独立临床文献相比，依赖临床研究报告的 PFA 结果更优，与第一代滑车表面置换植入物相比，滑车切割型 PFA 的结果更优。
系统回顾了 1955 年以来 PFA 上市后的所有研究。在索引的同行评审国际科学期刊上发表的 45 项研究中，评估了 45 项研究中计算的翻修率（每 100 个组件年的翻修率）。此外，还分析了第一代滑车表面置换和滑车切割植入物，以及依赖和独立的临床文献。此外，还分析了三个关节置换登记处的数据。
共纳入 15306 例 PFA，其中包括 2266 例来自全球文献数据，13040 例来自登记数据。在全球文献数据中，每 100 个 CY 观察到 2.22 次翻修，10 年后翻修率为 22.2%。纳入的三个国家关节登记处显示，10 年后的翻修率在 18.9%至 27%之间。在组分析中未发现显著差异。
本荟萃分析未发现开发者出版物与独立出版物之间、第一代表面置换与滑车切割植入物之间的比较存在显著差异。因此，开发者出版物的数据似乎没有偏差。PFA 的滑车切割装置的结果略优，但无统计学意义。尽管如此，我们仍建议在 PFA 中进一步使用滑车切割装置。
四级病例系列的荟萃分析。
