Sappey-Marinier Elliot, Pauvert Adrien, Batailler Cécile, Swan John, Cheze Laurence, Servien Elvire, Lustig Sébastien
FIFA medical center of excellence, Orthopaedics Surgery and Sports Medicine Department, Croix-Rousse Hospital, Hospices Civils de Lyon, 103 Grande rue de la Croix Rousse, 69004 Lyon, France.
Univ Lyon, Claude Bernard Lyon 1 University, IFSTTAR, LBMC UMR_T9406, 69622 Lyon, France.
SICOT J. 2020;6:18. doi: 10.1051/sicotj/2020014. Epub 2020 Jun 17.
The aim of this study was to perform a systematic review of the literature to determine whether there are any clinical or radiological differences in mechanically aligned Total Knee Arthroplasty (TKA) compared with kinematically aligned TKA.
This study included retrospective cohort studies, prospective randomized controlled trials (PRCTs) and prospective cohort studies comparing clinical and radiological outcomes, and complications in TKA with kinematic alignment (KA) and mechanical alignment (MA). All studies had a minimum follow-up of 2 years.
Five PRCTs published between 2014 and 2020 were included. These studies showed a low risk of bias and were of very high quality. We did not find a superiority of KA compared to MA technique for clinical and radiological outcomes, except in one study which showed a significant difference favoring KA between the two groups for all clinical scores.
We found that KA in TKA achieved clinical and radiological results similar to those of MA. The complication rate was not increased for KA TKAs. Studies with longer follow-up and larger cohorts are required to prove any benefit of KA technique over MA technique.
本研究旨在对文献进行系统综述，以确定与运动学对齐的全膝关节置换术（TKA）相比，机械对齐的TKA在临床或放射学上是否存在差异。
本研究纳入了回顾性队列研究、前瞻性随机对照试验（PRCT）以及比较TKA采用运动学对齐（KA）和机械对齐（MA）时临床和放射学结果及并发症的前瞻性队列研究。所有研究的最短随访时间均为2年。
纳入了2014年至2020年间发表的5项PRCT。这些研究显示偏倚风险较低且质量非常高。除一项研究显示两组所有临床评分中KA明显占优外，我们未发现KA在临床和放射学结果方面优于MA技术。
我们发现TKA中的KA在临床和放射学结果上与MA相似。KA TKA的并发症发生率并未增加。需要进行更长随访时间和更大样本量队列的研究来证明KA技术相对于MA技术的任何优势。
