Department of Special Surgery, Division of Orthopedics, School of Medicine, The University of Jordan, Amman, Jordan.
School of Medicine, The University of Jordan, Amman, 11942, Jordan.
J Orthop Surg Res. 2024 Nov 14;19(1):756. doi: 10.1186/s13018-024-05256-z.
Total knee arthroplasty (TKA) is a widely performed procedure that significantly enhances patients' quality of life by reducing pain and improving daily function. While the traditional tibial plate design used in TKA has been symmetrical, there has been a recent trend towards using asymmetrical designs. Our study aimed to compare symmetrical and asymmetrical tibial designs, focusing on outcomes related to overhang, malrotation, and tibial coverage.
This systematic review was conducted in accordance with PRISMA guidelines. A comprehensive search of PubMed, Scopus, Web of Science, and Cochrane databases was carried out up to January 22nd, 2024, to identify comparative studies on symmetrical and asymmetrical designs, as well as those reporting postoperative functional and clinical outcomes. The risk of bias in the included studies was evaluated using the Newcastle-Ottawa Scale (NOS).
This systematic review included 587 patients from seven comparative studies that met the inclusion criteria. Our findings indicate that asymmetrical tibial components generally provided better outcomes in terms of tibial coverage, malrotation, and overhang. Asymmetrical designs provided greater tibial coverage and reduced posterolateral overhang compared to symmetrical designs, which is essential for minimizing complications like soft tissue irritation and patellar maltracking. Additionally, asymmetrical components were associated with less severe tibial malrotation.
This systematic review showed that asymmetrical tibial implants offer better tibial coverage, with less overhang and fewer rotational issues compared to symmetrical implants. As a result, asymmetrical designs in TKA may lower complication rates, enhance patient satisfaction, and improve quality of life post-surgery.
全膝关节置换术（TKA）是一种广泛开展的手术，通过减轻疼痛和改善日常功能，显著提高了患者的生活质量。虽然 TKA 中传统的胫骨平台设计是对称的，但最近出现了使用非对称设计的趋势。我们的研究旨在比较对称和非对称胫骨设计，重点关注与突出、旋转不良和胫骨覆盖相关的结果。
本系统评价按照 PRISMA 指南进行。对 PubMed、Scopus、Web of Science 和 Cochrane 数据库进行了全面检索，检索时间截至 2024 年 1 月 22 日，以确定关于对称和非对称设计以及报告术后功能和临床结果的比较研究。使用纽卡斯尔-渥太华量表（NOS）评估纳入研究的偏倚风险。
本系统评价纳入了 7 项符合纳入标准的比较研究中的 587 名患者。我们的研究结果表明，非对称胫骨组件在胫骨覆盖、旋转不良和突出方面通常提供更好的结果。与对称设计相比，非对称设计提供了更大的胫骨覆盖和减少了后外侧突出，这对于最小化软组织刺激和髌骨脱位等并发症至关重要。此外，非对称组件与较轻的胫骨旋转不良相关。
本系统评价表明，与对称植入物相比，非对称胫骨植入物提供了更好的胫骨覆盖，突出和旋转问题更少。因此，TKA 中的非对称设计可能会降低并发症发生率，提高患者满意度，并改善术后生活质量。
