Evidence map›Paper›PMID 32242268›Full record

SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2021

Influence of component design on in vivo tibiofemoral contact patterns during kneeling after total knee arthroplasty: a systematic review and meta-analysis.

Joseph T Lynch, Jennie M Scarvell, Catherine R Galvin, Paul N Smith, Diana M Perriman

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Joseph T LynchThe Trauma and Orthopaedic Research Unit, Australian National University, The Canberra Hospital, Building 6, Level 1, Garran, ACT, Australia. Joseph.lynch@anu.edu.au.
Jennie M ScarvellFaculty of Health, University of Canberra, Canberra, ACT, Australia.
Catherine R GalvinCollege of Engineering and Computer Science, Australian National University, Acton, ACT, Australia.
Paul N SmithThe Trauma and Orthopaedic Research Unit, Australian National University, The Canberra Hospital, Building 6, Level 1, Garran, ACT, Australia.
Diana M PerrimanThe Trauma and Orthopaedic Research Unit, Australian National University, The Canberra Hospital, Building 6, Level 1, Garran, ACT, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeModern TKR prostheses are designed to restore healthy kinematics including high flexion. Kneeling is a demanding high-flexion activity. There have been many studies of kneeling kinematics using a plethora of implant designs but no comprehensive comparisons. Visualisation of contact patterns allows for quantification and comparison of knee kinematics. The aim of this systematic review was to determine whether there are any differences in the kinematics of kneeling as a function of TKR design.

methodsA search of the published literature identified 26 articles which were assessed for methodologic quality using the MINORS instrument. Contact patterns for different implant designs were compared at 90° and maximal flexion using quality-effects meta-analysis models.

resultsTwenty-five different implants using six designs were reported. Most of the included studies had small-sample sizes, were non-consecutive, and did not have a direct comparison group. Only posterior-stabilised fixed-bearing and cruciate-retaining fixed-bearing designs had data for more than 200 participants. Meta-analyses revealed that bicruciate-stabilised fixed-bearing designs appeared to achieve more flexion and the cruciate-retaining rotating-platform design achieved the least, but both included single studies only. All designs demonstrated posterior-femoral translation and external rotation in kneeling, but posterior-stabilised designs were more posterior at maximal flexion when compared to cruciate retaining. However, the heterogeneity of the mean estimates was substantial, and therefore, firm conclusions about relative behaviour cannot be drawn.

conclusionThe high heterogeneity may be due to a combination of variability in the kneeling activity and variations in implant geometry within each design category. There remains a need for a high-quality prospective comparative studies to directly compare designs using a common method. LEVEL OF EVIDENCE: Systematic review and meta-analysis Level IV.

Indexed as

Knee ProsthesisProsthesis DesignAdultAgedAged, 80 and overArthroplasty, Replacement, KneeBiomechanical PhenomenaFemaleFemurHumansKneeKnee JointMaleMiddle AgedPosterior Cruciate LigamentPostureContact patternsKneelingSystematic reviewTotal knee replacement

Identifiers

PMID32242268

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.