Absence d’avantage sur l’alignement frontal des prothèses de genou posées avec ancillaire personnalisé : revue systématique et méta-analyse - 21/05/15
No demonstrable benefit for coronal alignment outcomes in PSI knee arthroplasty: A systematic review and meta-analysis
, T.O. Smith b, C. Sagar a, N.J. London c, P.J.A. Molitor aAbstract |
Aim |
A systematic review and meta-analysis of clinical studies assessing alignment outcomes in patient- specific instrumented (PSI) knee arthroplasty was conducted.
Materials and methods |
PRISMA compliant data was extracted from literature databases up to January 2014.
Results |
Twenty-six studies met the inclusion criteria, reporting a total of 1792 knees. Twenty-three studies reported alignment outcomes in the coronal plane, 11 in the sagittal plane. In all but three series, MRI was the pre-operative imaging modality. Range of mean post-operative alignment (Hip Knee Ankle [HKA] angle) was 176.5 to 181.70. The proportion of three degrees of outliers showed an overall mean of 18.6%. In total, fifteen studies compared alignment outcomes between standard and PSI. From these, four studies showed significantly higher accuracy of coronal plane alignment with PSI (HKAangle). Meta-analysis of seven high-quality comparative studies demonstrated no significant increased accuracy in post-operative mechanical axis (HKAangle) with PSI. Sub-group meta-analysis of both femoral and tibial rotation was not feasible due to a low number of inclusive high-quality series.
Conclusions |
Further studies are required to demonstrate both clinical and radiological alignment outcomes in PSI knee arthroplasty with focus upon tibial and femoral rotation.
Level of evidence |
1
Le texte complet de cet article est disponible en PDF.Keywords : Total knee arthroplasty, Patient specific instrumentation, Computer assisted surgery, Meta-analysis
| ☆ | Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (www.sciencedirect.com/) en utilisant le DOI ci-dessus. |
Vol 101 - N° 4
P. 299 - juin 2015 Retour au numéro
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