Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, No. 59, Haier Road, Qingdao, 266000, China.
Medical Department of Qingdao University, Qingdao, 266071, Shandong, China.
J Orthop Surg Res. 2022 Aug 19;17(1):395. doi: 10.1186/s13018-022-03285-0.
We aimed to compare the postoperative clinical efficacy and safety of medial pivot (MP) prosthesis and posterior-stabilized (PS) prosthesis in the treatment of knee osteoarthritis (KOA).
All studies involving MP and PS prosthesis in PubMed, EMBASE, Cochrane Library, and Web of Science were searched since the establishment of the database. The included outcomes were knee range of motion (ROM), functional score, radiographic results, complication rate, and revision rate. Studies were independently evaluated by the Newcastle-Ottawa Scale for case-control studies and the assessment tool of the Cochrane Collaboration for randomized controlled trials. I was used to test the heterogeneity, and fixed- or random-effects models were selected for meta-analysis according to the heterogeneity results.
A total of 19 studies, consisting of 3592 patients and 3783 knees (MP: 1811 knees, PS: 1972 knees), were included in the meta-analysis. The WOMAC (MD = - 1.11, 95% CI - 1.98 to - 0.23; P = 0.01) and HSS (MD = - 4.32, 95% CI - 8.30 to - 0.34; P = 0.03) in the MP group were significantly lower compared with the PS group, and the complication rate (OR 0.53, 95% CI 0.33-0.87; P = 0.01) was also lower compared with the PS group. There was no significant difference in ROM, radiographic results, and revision rate between the two groups (P > 0.5).
The existing literature provided evidence to support better clinical effect and lower complication rate of MP prosthesis compared to PS prosthesis. These results provide a reference for clinicians when choosing a suitable prosthesis.
比较内侧铰链（MP）假体和后稳定（PS）假体治疗膝骨关节炎（KOA）的术后临床疗效和安全性。
自数据库建立以来，在 PubMed、EMBASE、Cochrane 图书馆和 Web of Science 中搜索了所有涉及 MP 和 PS 假体的研究。纳入的结果包括膝关节活动度（ROM）、功能评分、影像学结果、并发症发生率和翻修率。使用纽卡斯尔-渥太华量表（Newcastle-Ottawa Scale）对病例对照研究进行独立评估，使用 Cochrane 协作工具（Cochrane Collaboration）对随机对照试验进行评估。使用 I² 检验评估异质性，根据异质性结果选择固定或随机效应模型进行荟萃分析。
共纳入 19 项研究，包括 3592 例患者和 3783 膝（MP：1811 膝，PS：1972 膝），纳入荟萃分析。MP 组的 WOMAC（MD = -1.11，95%CI -1.98 至 -0.23；P = 0.01）和 HSS（MD = -4.32，95%CI -8.30 至 -0.34；P = 0.03）评分明显低于 PS 组，并发症发生率（OR 0.53，95%CI 0.33-0.87；P = 0.01）也低于 PS 组。两组 ROM、影像学结果和翻修率无显著差异（P > 0.5）。
现有文献证据支持 MP 假体与 PS 假体相比，具有更好的临床效果和更低的并发症发生率。这些结果为临床医生选择合适的假体提供了参考。
