Evidence map›Paper›PMID 33746421›Full record

ReviewJournal of orthopaedics

Is varus-valgus constraint a reliable option in complex primary total knee arthroplasty? A systematic review.

Fabio Mancino, Francesco Falez, Fabrizio Mocini, Peter K Sculco, Giulio Maccauro, Ivan De Martino

Open access · greenAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Journal of orthopaedics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
2.9field-weighted citation impact, top 9% of its field
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

6 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
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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

6 authors at 4 institutions in 2 countries.

Fabio MancinoAdult Reconstruction and Joint Replacement Service, Division of Orthopaedics and Traumatology, Department of Aging, Neurological, Orthopaedic and Head-Neck studies, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, Roma, RM, 00168, Italy.
Francesco FalezDepartment of Orthopaedics and Traumatology, ASL Roma 1, S. Filippo Neri Hospital, Via G. Martinotti 20, 00135, Rome, Italy.
Fabrizio MociniAdult Reconstruction and Joint Replacement Service, Division of Orthopaedics and Traumatology, Department of Aging, Neurological, Orthopaedic and Head-Neck studies, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, Roma, RM, 00168, Italy.
Peter K SculcoStavros Niarchos Foundation Complex Joint Reconstruction Center, Adult Reconstruction and Joint Replacement Division, Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, United States.
Giulio MaccauroAdult Reconstruction and Joint Replacement Service, Division of Orthopaedics and Traumatology, Department of Aging, Neurological, Orthopaedic and Head-Neck studies, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, Roma, RM, 00168, Italy.
Ivan De MartinoAdult Reconstruction and Joint Replacement Service, Division of Orthopaedics and Traumatology, Department of Aging, Neurological, Orthopaedic and Head-Neck studies, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, Roma, RM, 00168, Italy.
Università Cattolica del Sacro Cuore · ITAgostino Gemelli University Polyclinic · ITASL Roma · ITHospital for Special Surgery · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeKnee instability is considered one of the most frequent cause of failure after primary total knee arthroplasty (TKA). In order to address intraoperative instability, varus-valgus constrained knee implants (VVC) are increasingly utilized in primary TKA. Despite an increased risk of mechanical failure, short to mid-term results seem to be encouraging, but long-term results are still lacking.

methodsA systematic review of prospective and retrospective studies that reported clinical outcomes of patients with VVC systems in primary TKAs between 1990 and 2020 was performed.

resultsIn all, 28 articles met our inclusion criteria. A total of 2798 VVC implants were used in primary TKA. The all-cause revision-free survivorship was 95.2% at a mean follow-up of 7 years. Infection and aseptic loosening were the most common reasons for reoperation with an incidence of 1.8% and 1.7%, respectively. Overall complication rate was 9.6%, the most common complications were knee stiffness and infection with an incidence of 2.8% and 2.5%, respectively.

conclusionsVVC implants in primary TKA are associated with improved functional outcomes and good mid-term survivorship, comparable to lower level of constraint implants. Non-modular stemless seem to be reliable implants at mid-term follow-up. However, given the lack data coming from long-term studies, VVC implants should be used cautiously in primary TKA.

Indexed as

Constrained total kneeCoronal deformityJoint laxityPrimary total knee arthroplastyVarus-valgus constraint

Identifiers

PMID33746421
PMCPMC7966964
OpenAlexW3133714658

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.