Meta-analysis of total knee arthroplasty guided by kinematic alignment and mechanical alignment / 中国组织工程研究

ABSTRACT

BACKGROUND: Although mechanical alignment technique ensures the long-term survival rate of knee arthrosis, some patients are still not satisfied with the effect of total knee arthroplasty and the function of knee joint after operation. OBJECTIVE: Meta-analysis was used to evaluate the effect of kinematic alignment technique and mechanical alignment technique in the guidance of total knee arthroplasty. METHODS: The literature of clinical controlled study of kinematic alignment and mechanical alignment in the guidance of total knee arthroplasty published from the date of establishment to July 2019 was searched in Chinese Biomedical Literature Database, Wanfang data, CNKI, VIP data, PubMed, Cochrane Library, and Embase. The literature was screened, and evaluated; data were extracted. Review Manager 5.3 software was used for statistical analysis. RESULTS AND CONCLUSION: (1) A total of 945 cases were included in 12 articles, including 470 cases in kinematic alignment group and 475 cases in mechanical alignment group. (2) The results of meta-analysis showed that the operation time was shorter in the kinematic alignment group than in the mechanical alignment group [MD=-15.44, 95%C/(-27.16, -3.71)]. Western Ontario and McMaster University Osteoarthritis Index was better in the kinematic alignment group than in the mechanical alignment group [MD=-8.40, 95%C/(-15.39, -1.40)]. Oxford knee score was better in the kinematic alignment group than in the mechanical alignment group [M7=4.72, 95%C/(0.24, 9.21)]. Distal angle of mechanical lateral femur and proximal angle of mechanical medial tibia were significantly larger in the mechanical alignment group than in the kinematic alignment group (all P 0.05). (4) The function of knee joint after kinematic alignment for guiding total knee arthroplasty was better than that in mechanical alignment group. However, the imaging and perioperative results were similar, and the incidence of complications was not increased after operation. It is suggested that kinematic alignment may be a lower extremity force alignment method to guide total knee arthroplasty.