Li Juntan, Zhang Yuqi, Gao Xiang, Dou Tianxu, Li Xu
Department of Orthopedics, The First Hospital of China Medical University, No.155 Nanjing North Street, Shenyang, Liaoning Province, 110001, People's Republic of China.
School of Public, Health China Medical University, No.77 Puhe Road, Shenyang, Liaoning Province, 110122, People's Republic of China.
Arthroplasty. 2022 Sep 2;4(1):35. doi: 10.1186/s42836-022-00135-6.
The aim of the study was to determine whether accelerometer-based navigation (ABN) can improve radiological and functional outcomes during total knee arthroplasty (TKA) compared with conventional techniques (CONV).
We comprehensively searched the PubMed, Embase, Web of Science, Cochrane Library, and Clinical Trials databases. Only randomized controlled trials were selected for meta-analysis and, ultimately, 10 studies were included.
The 10 studies involved 1,125 knees, of which 573 were in the ABN group and 552 in the CONV group. The results demonstrated that ABN significantly reduced the number of outliers for mechanical alignment (MA) (RR: 0.38, 95% CI: 0.27 to 0.54, P < 0.00001, I = 45%), achieving more accurate MA (RR: -0.78, 95% CI: -0.93 to -0.62, P < 0.00001, I = 76%). The results revealed that there was no significant difference in duration of surgery between the ABN and CONV groups (MD: -0.2, 95% CI: -1.45 to 1.05, P = 0.75, I = 48%). There was less blood loss through the use of ABN (SMD: -0.49, 95% CI: -0.93 to -0.06, P = 0.03, I = 75%). However, ABN group didn't show better knee function (SMD: 0.13, 95% CI: -0.07 to 0.33, P = 0.20, I = 0%), though the incidence of overall complications was significantly lower (RR: 0.69, 95% CI: 0.50 to 0.95, P = 0.02, I = 0%).
The present meta-analysis demonstrated that ABN was superior to CONV in restoring MA of the lower limb. In addition, ABN reduced the loss of blood and the duration of surgery was not prolonged. However, patient-reported outcome measurements (PROMs) were not improved.
本研究的目的是确定与传统技术（CONV）相比，基于加速度计的导航（ABN）在全膝关节置换术（TKA）中是否能改善放射学和功能结果。
我们全面检索了PubMed、Embase、Web of Science、Cochrane图书馆和临床试验数据库。仅选择随机对照试验进行荟萃分析，最终纳入10项研究。
10项研究涉及1125个膝关节，其中ABN组573个，CONV组552个。结果表明，ABN显著减少了机械对线（MA）的异常值数量（RR：0.38，95%CI：0.27至0.54，P＜0.00001，I²=45%），实现了更准确的MA（RR：-0.78，95%CI：-0.93至-0.62，P＜0.00001，I²=76%）。结果显示，ABN组和CONV组的手术时间无显著差异（MD：-0.2，95%CI：-1.45至1.05，P=0.75，I²=48%）。使用ABN失血更少（SMD：-0.49，95%CI：-0.93至-0.06，P=0.03，I²=75%）。然而，ABN组的膝关节功能并未更好（SMD：0.13，95%CI：-0.07至0.33，P=0.20，I²=0%），尽管总体并发症发生率显著更低（RR：0.69，95%CI：0.50至0.95，P=0.02，I²=0%）。
本荟萃分析表明，ABN在恢复下肢MA方面优于CONV。此外，ABN减少了失血量且未延长手术时间。然而，患者报告的结局指标（PROMs）并未改善。
