No difference in clinical outcome between patella eversion and lateral retraction in total knee arthroplasty: a systemic review and meta-analysis

Abstract

Systematic review and meta-analysis, Level I.

Should the patella be everted during primary total knee arthroplasty? A systematic review of overlapping meta-analyses

“…The meta-analysis by Zan et al 7 was selected independently by all the evaluating authors as the study of the highest quality according to the Jadad algorithm.…”

“…Jia et al 9 Zan et al 7 Yang et al 8 Walter et al 11 þ þ þ Dalury et al 10 þ Arnout et al 15 þ þ þ Umrani et al 12 þ þ þ Reid et al 13 þ þ þ Jenkins et al 14 þ þ þ Regarding clinical evaluation score, KSS collected at 3 months after surgery showed no significant difference between the groups (mean difference ¼ À3.03 points; 95% confidence interval ¼ À13.55 to 7.50; p ¼ n.s. ); no significant differences were found comparing Short-Form 36 PCS and MCS at 1 year after surgery in a different study; VAS score was reported in different forms and times, and no analysis could be performed.…”

“…Jia et al 9 Zan et al 7 Journal of Orthopaedic Surgery 27 (1) tendon during surgery could lower the risk of postoperative patella infera caused by fibrotic reaction of the tendon to the increased traction and minimize the risk of patellar tendon avulsion from tibial tuberosity. However, this statement could not be confirmed as there were nonsignificant differences between noneversion and eversion regarding patella infera (assessed with Insall-Salvati ratio) and patellar tendon avulsion relative incidence.…”

“…All the three meta-analyses included only RCTs and were therefore determined as level of evidence I. Quality appraisal was performed with the Consolidated Standards Of Reporting Trials (CONSORT) in two meta-analyses, 7,8 whereas one applied the Cochrane Risk of Bias Tool. 9 Only one meta-analysis reported to follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, while none of the three performed a sensitivity analysis, a publication bias evaluation or reported the evidences according to the GRADE principles (Table 4).…”

“…Restriction of publication status PubMed MEDLINE Embase Cochrane Library CINAHL Others Jia et al 9 No No þ þ þ Zan et al 7 No Yes þ þ þ þ þ Yang et al 8 Yes No þ þ þ þ Figure 2. Summary table for the outcomes of the included meta-analyses.…”