Wang Guiguan, Chen Long, Xu Jie
Shengli Clinical Medical College of Fujian Medical University, Fujian Medical University, Fuzhou 350001, China; Department of Orthopedic, Fujian Provincial Hospital, Fuzhou 350001, China.
Department of Orthopedic, Fujian Provincial Hospital, Fuzhou 350001, China.
J Orthop Sci. 2024 Sep;29(5):1226-1234. doi: 10.1016/j.jos.2023.08.001. Epub 2023 Aug 10.
Kinematic and mechanical alignment outcomes in total knee arthroplasty remain controversial. This study compared the clinical and radiological outcomes of total knee arthroplasty using kinematic and mechanical alignments.
We systematically searched PubMed, EMBASE, Web of Science, and Cochrane Library databases for randomized controlled trials and cohort studies published before November 2022. The data of interest were extracted and analyzed using Review Manager V.5.4.
Nineteen randomized controlled trials and cohort studies involving 880 kinematic alignment total knee arthroplasties and 965 mechanical alignment total knee arthroplasties were included. In this meta-analysis, the kinematic alignment group achieved better knee joint function scores, including the Oxford Knee Score, Knee Injury and Osteoarthritis Outcome Score, and Knee Society Score, and better flexion angles. No statistical differences were detected in the Western Ontario and McMaster Universities Osteoarthritis Index, extension angle, Forgotten Joint Score, European Quality of Life five-dimension measure, hip-knee-ankle angle, or complications between the kinematic and mechanical alignment groups.
This meta-analysis indicated that kinematic alignment total knee arthroplasty provides clinical benefits in terms of the Oxford Knee Score, Knee Injury and Osteoarthritis Outcome Score, Knee Society Score (knee), Knee Society Score (function), and better flexion angles. In addition, kinematic alignment total knee arthroplasty led to similar clinical outcomes as mechanical alignment total knee arthroplasty without increasing complications.
全膝关节置换术中的运动学和机械对线结果仍存在争议。本研究比较了采用运动学对线和机械对线的全膝关节置换术的临床和放射学结果。
我们系统检索了PubMed、EMBASE、Web of Science和Cochrane图书馆数据库，以查找2022年11月之前发表的随机对照试验和队列研究。使用Review Manager V.5.4提取并分析感兴趣的数据。
纳入了19项随机对照试验和队列研究，涉及880例运动学对线全膝关节置换术和965例机械对线全膝关节置换术。在这项荟萃分析中，运动学对线组获得了更好的膝关节功能评分，包括牛津膝关节评分、膝关节损伤和骨关节炎转归评分以及膝关节协会评分，并且屈曲角度更好。在西安大略和麦克马斯特大学骨关节炎指数、伸展角度、遗忘关节评分、欧洲生活质量五维度量表、髋-膝-踝角度或运动学对线组与机械对线组之间的并发症方面未检测到统计学差异。
这项荟萃分析表明，运动学对线全膝关节置换术在牛津膝关节评分、膝关节损伤和骨关节炎转归评分、膝关节协会评分（膝关节）、膝关节协会评分（功能）以及更好的屈曲角度方面具有临床益处。此外，运动学对线全膝关节置换术与机械对线全膝关节置换术具有相似的临床结果，且未增加并发症。
