Evidence map›Paper›PMID 32396538›Full record

SynthesisPloS one2020

Hydroxyapatite-coated implants provide better fixation in total knee arthroplasty. A meta-analysis of randomized controlled trials.

Tamara Horváth, Lilla Hanák, Péter Hegyi, Edina Butt, Margit Solymár, Ákos Szűcs, Orsolya Varga, Bui Quoc Thien, Zsolt Szakács, Endre Csonka and 1 more

Abstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing 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

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

  1. Pooled it
  2. [Effectiveness of cementless total knee arthroplasty with three-dimensional-printed trabecular metal interface].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026
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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

11 authors.

Tamara HorváthInstitute of Surgical Research, University of Szeged, Szeged, Hungary.
Lilla HanákInstitute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.
Péter HegyiInstitute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.
Edina ButtDepartment of Traumatology, University of Szeged, Szeged, Hungary.
Margit SolymárInstitute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.
Ákos SzűcsDepartment of Surgery, University of Semmelweis, Budapest, Hungary.
Orsolya VargaDepartment of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
Bui Quoc ThienDepartment of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.ORCID 0000-0001-7476-2946
Zsolt SzakácsInstitute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.ORCID 0000-0002-7035-941X
Endre CsonkaDepartment of Traumatology, University of Szeged, Szeged, Hungary.
Petra HartmannInstitute of Surgical Research, University of Szeged, Szeged, Hungary.ORCID 0000-0002-4746-9792

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe potential advantages of hydroxyapatite (HA)-coated cementless total knee arthroplasty (TKA) implants are bone stock preservation and biological fixation. Studies comparing the outcomes of HA-coated cementless, non HA-coated cementless (uncemented) and cemented TKA implants reported contradictory data. Our aim was to provide a comparison of the effects of HA coating of tibial stem on the stability and functionality of TKA implants.

methodsA systematic literature search was performed using MEDLINE, Scopus, EMBASE and the CENTRAL databases up to May 31st, 2019. The primary outcome was Maximum Total Point Motion (MTPM) of the tibial stem. This parameter is determined by radiosterometric analysis and refers to the migration pattern of the prosthesis stems. The clinical outcomes of the implanted joints were evaluated by the Knee Society Knee Score (KSS) and the Knee Society Function Score (KFS). Weighted mean difference (WMD) with 95% confidence interval (CI) were calculated with the random-effects model.

resultsAltogether, 11 randomized controlled trials (RCTs) with 902 patients for primary TKA implants were included. There was a statistically significant difference in the MTPM values with the use of HA-coated and uncoated uncemented implants (WMD = +0.28, CI: +0.01 to +0.56, P<0.001). However, HA-coated stems showed significantly higher migration when compared with the cemented prostheses (WMD = -0.29, CI: -0.41 to -0.16, P<0.001). The KSS values of HA-coated implants were significantly higher than those for the uncemented implants; moreover, KSS and KFS outcome scores were statistically not different between the HA-coated and cemented prosthesis cases.

conclusionHA-coating yields better stability than other, uncemented prostheses. More importantly, the HA-coating is not outperformed by cemented prosthesis in providing good functional outcome.

Indexed as

DurapatiteKnee ProsthesisRandomized Controlled Trials as TopicArthroplasty, Replacement, KneeHumansTreatment OutcomeDurapatite

Identifiers

PMID32396538
PMCPMC7217427

What OpenQuestion holds

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Registered trials

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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.