International Orthopaedics ( IF 2.0 ) Pub Date : 2022-08-29 , DOI: 10.1007/s00264-022-05553-4 Safa Abulhail 1 , Shamsi Hameed 1 , Maamoun Abousamhadaneh 1 , Ghalib Al Haneedi 1 , Mohamed Al Ateeq Aldosari 1
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Purpose
Total knee arthroplasty is one of the significantly evolving procedures with different knee designs available in the market. The continued development of these prosthesis resulted in improvement of the implant survivorship and patient satisfaction. This study is an RCT-based meta-analysis aimed to compare two designs of total knee replacement: the conventional modular and the monoblock trabecular metal tibial trays.
Methods
This meta-analysis was performed by a literature review according to the PRISMA guidelines. A detailed search of the English literature was done using the PubMed, Medline, CINAHL, Cochrane, Embase, and Google Scholar databases. Only randomized control trials were included in the analysis after ensuring homogeneity. RevMan V.5.0.18.33 (The Cochrane Collaboration, Copenhagen, Denmark) was used to perform the meta-analysis. Extracted outcome measures were Knee Society score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, survivorship, complication rate, and radiostereographic analysis.
Results
Seven randomized control trials with 635 patients were eligible for our analysis after they met our inclusion criteria. Three hundred twelve patients received monoblock tibias, and the other 323 patients received modular tibial trays during their total knee arthroplasty surgeries. There were statistically significant superiority of the modular knees in the functional Knee Society and WOMAC scores at five years (P = 0.003 and 0.05, respectively). The modular design was also more stable on RSA at two years (P < 0.0001).
Conclusion
Modular and monoblock tibial trays are comparable knee designs with comparable survivorship and complication rates. However, the modular knees had better mid-term functional outcome and are more stable on radiostereographic analysis.
中文翻译：
全膝关节置换术中的小梁金属整体式与模块化胫骨托：随机对照试验的荟萃分析
目的
全膝关节置换术是一种显着发展的手术，市场上有不同的膝关节设计。这些假体的持续发展提高了植入物的存活率和患者满意度。本研究是一项基于随机对照试验的荟萃分析，旨在比较两种全膝关节置换设计：传统模块化和整体式小梁金属胫骨托。
方法
该荟萃分析是根据 PRISMA 指南通过文献综述进行的。使用 PubMed、Medline、CINAHL、Cochrane、Embase 和 Google Scholar 数据库对英语文献进行了详细搜索。在确保同质性后，仅将随机对照试验纳入分析。RevMan V.5.0.18.33（The Cochrane Collaboration，哥本哈根，丹麦）用于进行荟萃分析。提取的结果指标是膝关节协会评分、西安大略大学和麦克马斯特大学骨关节炎指数 (WOMAC) 评分、生存率、并发症发生率和放射立体图分析。
结果
在满足我们的纳入标准后，有 635 名患者参与的七项随机对照试验符合我们的分析条件。312 名患者在全膝关节置换术中接受了整体胫骨，另外 323 名患者接受了模块化胫骨托。在 5 年的功能性膝关节协会和 WOMAC 评分中，模块化膝关节具有统计学显着优势（分别为P = 0.003 和 0.05）。两年后，模块化设计在 RSA 上也更稳定 ( P < 0.0001)。
结论
模块化和整体式胫骨托是可比的膝关节设计，具有可比的存活率和并发症发生率。然而，模块化膝关节具有更好的中期功能结果，并且在放射立体图分析中更稳定。
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