全膝关节置换术的机械对线与运动学对线：一项荟萃分析。
Mechanical versus kinematic alignment for total knee arthroplasty: a meta-analysis.
作者信息
Migliorini Filippo, Maffulli Nicola, Pilone Marco, Schäfer Luise, Ullmann David, Huber Thorsten, Rath Björn
机构信息
Department of Orthopedics and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), 39100, Bolzano, Italy.
Department of Life Sciences, Health, and Health Professions, Link Campus University, 00165, Rome, Italy.
出版信息
Arch Orthop Trauma Surg. 2025 Mar 25;145(1):212. doi: 10.1007/s00402-025-05835-7.
INTRODUCTION
The present meta-analysis compared mechanical versus kinematic alignment in total knee arthroplasty (TKA). The outcomes of interest were patient-reported outcome measures (PROMs), range of motion (ROM), and revision rate.
METHODS
This study was conducted according to the 2020 PRISMA statement. In July 2024, PubMed, Web of Science, Google Scholar, and Embase were accessed without time constraints. All the clinical studies that compared mechanical versus kinematic alignment in total knee arthroplasty were accessed.
RESULTS
30 studies (3133 TKAs) were collected. The mean duration of the follow-up was 30.8 ± 38 months. No difference was found in Knee KSS-F, Knee Society Score (KSS, P = 0.2) and its function subscale (P = 0.3), visual analogue scale (VAS, P = 0.3), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC, P = 0.2), Oxford Knee Score (OKS, P = 0.5). No difference was found in the rate of revision (P = 0.4). The ROM was slightly greater in the kinematic group (P < 0.0001).
CONCLUSION
PROMs and revision did not show a difference between mechanical and kinematic alignment in TKA. However, a minimal difference in the ROM was evidenced, which probably does not have clinical relevance.
LEVEL OF EVIDENCE
Level IV, systematic review and meta-analysis.
引言
本荟萃分析比较了全膝关节置换术（TKA）中机械对线与运动学对线的效果。感兴趣的结果指标包括患者报告的结局测量（PROMs）、活动范围（ROM）和翻修率。
方法
本研究按照2020年PRISMA声明进行。2024年7月，对PubMed、科学网、谷歌学术和Embase进行了无时间限制的检索。纳入了所有比较全膝关节置换术机械对线与运动学对线的临床研究。
结果
共收集到30项研究（3133例TKA）。平均随访时间为30.8±38个月。在膝关节KSS-F、膝关节协会评分（KSS，P = 0.2）及其功能子量表（P = 0.3）、视觉模拟评分（VAS，P = 0.3）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC，P = 0.2）、牛津膝关节评分（OKS，P = 0.5）方面未发现差异。在翻修率方面也未发现差异（P = 0.4）。运动学组的ROM略大（P < 0.0001）。
结论
在全膝关节置换术中，PROMs和翻修率在机械对线与运动学对线之间未显示出差异。然而，ROM存在极小差异，可能不具有临床相关性。
证据级别
IV级，系统评价和荟萃分析。
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