Meta-Review of the Quantity and Quality of Evidence for Knee Arthroplasty Devices

Gagliardi, Anna R.; Ducey, Ariel; Lehoux, Pascale; Ross, Sue; Trbovich, Patricia; Easty, Anthony C.; Bell, Chaim M.; Takata, Julie; Pabinger, Christof; Urbach, David R.

doi:10.1371/journal.pone.0163032

Cited by 9 publications

(9 citation statements)

References 22 publications

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“…The continuous drop of average citations by each period can be explained by the young age and therefore less time for being citated as well as the rising number of overall publications. Unlike recent studies [ 1 , 8 ], the current analysis failed to find an increasing LOE over time, likely because the LOE was not regularly reported between 2006 and 2010. The mentioned articles demonstrated an increase in the LOE of publications between 2004 and 2018, confirming the increasing quality and perhaps the sophistication of research questions over time to confirm the mentioned hypothesis.…”

Section: Discussioncontrasting

confidence: 98%

“…The average number of authors was 5 [1][2][3][4][5][6][7][8][9] between 2006 and 2010, 5 [1][2][3][4][5][6][7][8][9][10][11][12][13][14] between 2011 and 2015 and 6 [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] between 2016 and 2020 (p < 0.001). This signiicant rise is demonstrated in detail by Fig.…”

Section: Authorship and Gender Characteristicsmentioning

confidence: 98%

“…Following, there is increasing interest in publication quality and internationalisation as well as gender disparity concerning authorship in the orthopaedic literature [ 3 , 4 , 7 , 12 ]. However, few literature sources have evaluated the level of evidence (LOE) in the field of knee arthroplasty [ 8 ]. Even less studies evaluate shift of trends in research topics but only represent felt trends or experts’ agreements [ 1 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

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Significant increase in quantity and quality of knee arthroplasty related research in KSSTA over the past 15 years

Kirschbaum

Kakzhad

Granrath

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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Purpose This study aimed to evaluate both publication and authorship characteristics in Knee Surgery, Sports Traumatology, Arthroscopy journal (KSSTA) regarding knee arthroplasty over the past 15 years. Methods PubMed was searched for articles published in KSSTA between January 1, 2006, and December 31st, 2020, utilising the search term ‘knee arthroplasty’. 1288 articles met the inclusion criteria. The articles were evaluated using the following criteria: type of article, type of study, main topic and special topic, use of patient-reported outcome scores, number of references and citations, level of evidence (LOE), number of authors, gender of the first author and continent of origin. Three time intervals were compared: 2006–2010, 2011–2015 and 2016–2020. Results Between 2016 and 2020, publications peaked at 670 articles (52%) compared with 465 (36%) published between 2011 and 2016 and 153 articles (12%) between 2006 and 2010. While percentage of reviews (2006–2010: 0% vs. 2011–2015: 5% vs. 2016–2020: 5%) and meta-analyses (1% vs. 6% vs. 5%) increased, fewer case reports were published (13% vs. 3% vs. 1%) (p < 0.001). Interest in navigation and computer-assisted surgery decreased, whereas interest in perioperative management, robotic and individualized surgery increased over time (p < 0.001). There was an increasing number of references [26 (2–73) vs. 30 (2–158) vs. 31 (1–143), p < 0.001] while number of citations decreased [30 (0–188) vs. 22 (0–264) vs. 6 (0–106), p < 0.001]. LOE showed no significant changes (p = 0.439). The number of authors increased between each time interval (p < 0.001), while the percentage of female authors was comparable between first and last interval (p = 0.252). Europe published significantly fewer articles over time (56% vs. 47% vs. 52%), whereas the number of articles from Asia increased (35% vs. 45% vs. 37%, p = 0.005). Conclusion Increasing interest in the field of knee arthroplasty-related surgery arose within the last 15 years in KSSTA. The investigated topics showed a significant trend towards the latest techniques at each time interval. With rising number of authors, the part of female first authors also increased—but not significantly. Furthermore, publishing characteristics showed an increasing number of publications from Asia and a slightly decreasing number in Europe. Level of evidence IV.

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Section: Discussioncontrasting

confidence: 98%

Section: Authorship and Gender Characteristicsmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Significant increase in quantity and quality of knee arthroplasty related research in KSSTA over the past 15 years

Kirschbaum

Kakzhad

Granrath

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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“…Ungeachtet der Schwächen der zitierten Arbeiten hat sich die Schnittmenge der Patienten, die potenziell sowohl mit einer unikondylären Oberflächenersatzprothese als auch mit einer bikondylären Oberflächenersatzprothese versorgt werden könnten, sukzessive vergrößert. Betrachtet man die zugrunde liegende Evidenz, fehlen jedoch klare Empfehlungen, ob oder in welcher Situation eines der beiden Verfahren zu bevorzugen ist [10].…”

Section: Methodsunclassified

AE-Beitrag: Unikondylärer Ersatz vs. Totalendoprothese bei medialer Gonarthrose

2017

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In end-stage medial osteoarthritis, the surgeon can decide whether to use unicompartmental or total knee arthroplasty for operative treatment of the patient. Despite the available literature there is a lack of evidence to suggest if one procedure can be rated as being superior to the other. With increasing demand for knee arthroplasty, treatment with the highest expectation of success will be of particular interest. The purpose of this manuscript was to analyse and compare the available literature on unicompartmental vs. total knee arthroplasty for the treatment of medial osteoarthritis. In this review of literature, the two procedures were compared regarding their clinical outcome, implant survival, and complication rates. Regarding the clinical outcome the unicompartmental knee arthroplasty was shown to be superior over total knee arthroplasty. However, studies were mostly retrospective and groups were also different preoperatively. Patients treated with unicompartmental knee arthroplasty had better preoperative range of motion and function scores. Unicompartmental and total knee arthroplasty showed comparably increased functional scores. Taking the implant survival as parameter, institutional registries, multicenter studies and arthroplasty registries found total knee arthroplasties to have a significantly better long-term survival in comparison to unicompartmental knee arthroplasty. However, data might be biased by the lower threshold to revise unicompartmental knee arthroplasty due to expected simple revision and more subjective indications for revision. Looking at the complication rate, one has to differentiate between general and implant-specific complications. While the unicompartmental knee arthroplasty was shown to be advantageous in terms of general complications and mortality, it was also shown to be inferior in terms of implant-specific complications. The available literature does not show one procedure to be superior to the other. The trend to a better clinical outcome and a lower mortality rate is advantageous for unicompartmental knee arthroplasty, while the better long-term survival and a lower risk of implant-specific complications may make total knee arthroplasty preferable.

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“…Although there have been no high-profile failures of knee implant design on the scale of metal-on-metal total hip replacements, patellofemoral KRs have a 3.6Â higher annual revision rate compared with TKR [6]. Furthermore, the evidence to support decisions about KR implants is limited [7]. The IDEAL collaboration, an influential agenda for surgical research, developed a framework for investigations into surgical innovations in which they recommended new medical devices have a phased introduction into surgical practice [8].…”

mentioning

confidence: 99%

The Uptake of New Knee Replacement Implants in the UK: Analysis of the National Joint Registry for England and Wales

Penfold

Blom

Wilkinson

et al. 2020

The Journal of Arthroplasty

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Background: Knee replacement (KR) surgery is one of the most common elective procedures in the UK. A large number of different KR implant brands are in use in the UK, which may contribute to variation in uptake and patient outcomes. Methods: A cohort of 722,178 primary KRs performed for osteoarthritis (with or without other indications) by 2675 consultant surgeons between 2008 and 2017 in England and Wales from the National Joint Registry was examined. We described the uptake of new (first use >2008) KR implant brands, and variation in uptake by consultant surgeons (primary objectives). We explored consultant-level/patient-level factors associated with use/receipt of new implant brands with multilevel logistic regression models (secondary objectives). Results: Sixty-five new KR implant brands were used in 22,134 KRs (3.1%) by 759 consultants (28.4%) between 2008 and 2017. Consultants used a median of 1 new brand (interquartile range ¼ 1-2, max ¼ 8) in 4.1% (interquartile range ¼ 1.1%-12.3%) of their KRs. Younger patients (<55 vs 55-80, odds ratio [OR] ¼ 1.63, 95% confidence interval [CI] ¼ 1.54-1.72) and women (OR ¼ 1.17, 95% CI ¼ 1.13-1.22) had higher odds of receiving a new rather than established brand. Consultants who used more different implant brands had higher odds of using new brands (OR/additional implant/year ¼ 2.57, 95% CI ¼ 2.37-2.79). Conclusion: A large number of new KR implant brands have been introduced in the National Joint Registry since 2008. A quarter of consultants have tried a new implant brand but have used them in only a small proportion of primary KRs in this period. Younger, healthier patients are more likely to receive new implant brands, and they are more likely to be used by surgeons who use many different implant brands.

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Meta-Review of the Quantity and Quality of Evidence for Knee Arthroplasty Devices

Cited by 9 publications

References 22 publications

Significant increase in quantity and quality of knee arthroplasty related research in KSSTA over the past 15 years

Significant increase in quantity and quality of knee arthroplasty related research in KSSTA over the past 15 years

AE-Beitrag: Unikondylärer Ersatz vs. Totalendoprothese bei medialer Gonarthrose

The Uptake of New Knee Replacement Implants in the UK: Analysis of the National Joint Registry for England and Wales

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