Department of Orthopedic, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Dongxiaokou Town, Changping District, Beijing, 102218, China.
FRCS (Edinburgh), Kuching Specialist Hospital, Tabuan Stutong Commercial Centre, 93350, Kuching, Sarawak, Malaysia.
J Orthop Surg Res. 2022 Apr 19;17(1):243. doi: 10.1186/s13018-022-03129-x.
Despite Vast improvements in technology and surgical technique in total knee arthroplasty (TKA), approximately 15-25% TKAs, have suboptimal subjective clinical outcomes. Our study sought to evaluate if sensor-guided balancing improves postoperative clinical outcomes compared to a conventional gap balancing technique.
We searched Web of Science, Embase, PubMed, Cochrane Controlled Trials Register, Cochrane Library, Highwire, CBM, CNKI, VIP, and Wanfang database in March 2022 to identify studies involving sensor-guided balancing versus conventional gap balancing technique in TKA. Finally, we identified 2147 knees assessed in nine studies.
Compared with manual gap balancing, Sensor-guided gap balancing resulted in less rate of Manipulation under anesthesia (MUA) (P = 0.02), however more rate of intraoperative additional procedures (P = 0.0003). There were no significant differences in terms of KSS (P = 0.21), KSS Function score (P = 0.36), OKS (P = 0.61), KOOS (P = 0.78), operative time (P = 0.17), Mechanical axis (P = 0.69) and rate of reoperation between two groups.
Compared with conventional manual gap balancing techniques, sensors have more balancing procedures being performed. However, it did result in a reduction in the rate of MUA. More extensive, high-quality RCTs are required to verify our findings further.
尽管全膝关节置换术(TKA)在技术和手术技术方面取得了巨大进步,但仍有约 15-25%的 TKA 术后临床效果不理想。我们的研究旨在评估传感器引导平衡是否比传统的间隙平衡技术更能改善术后临床结果。
我们于 2022 年 3 月在 Web of Science、Embase、PubMed、Cochrane 对照试验登记处、Cochrane 图书馆、Highwire、CBM、CNKI、VIP 和万方数据库中进行了检索,以确定涉及 TKA 中传感器引导平衡与传统间隙平衡技术的研究。最后,我们确定了 9 项研究中评估的 2147 个膝关节。
与手动间隙平衡相比,传感器引导间隙平衡导致麻醉下手法复位(MUA)的发生率较低(P=0.02),但术中附加手术的发生率较高(P=0.0003)。在 KSS(P=0.21)、KSS 功能评分(P=0.36)、OKS(P=0.61)、KOOS(P=0.78)、手术时间(P=0.17)、机械轴(P=0.69)和两组之间的再手术率方面,无显著差异。
与传统的手动间隙平衡技术相比,传感器进行了更多的平衡程序。然而,它确实降低了 MUA 的发生率。需要进行更多广泛、高质量的 RCT 来进一步验证我们的发现。