Evidence map›Paper›PMID 36803522›Full record

ArticleJournal of orthopaedic surgery and research2023

Optimal surgical treatment for periprosthetic distal femoral fractures after total knee arthroplasty: a Bayesian-based network analysis.

Peng Fu, Wenwei Liang, Zhenzhen Gao, Gang Chen, Weimin Fan

Open access · goldAbstract readLetterNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of orthopaedic surgery and research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.9field-weighted citation impact, top 10% 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

5 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. Outcomes of locked plating and retrograde intramedullary nailing for periprosthetic distal femur fractures after TKA.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025
    Article
  4. Article
  5. Review
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 at 3 institutions in 1 country.

Peng Fu *Department of Orthopaedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Wenwei Liang *Department of Orthopaedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Zhenzhen GaoDepartment of Clinical Oncology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China.
Gang ChenDepartment of Orthopaedics, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China.
Weimin FanDepartment of Orthopaedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China. ludanbeko0907@163.com.
Jiaxing University · CNNanjing Medical University · CNJiangsu Province Hospital · CN

Funding

Jiaxing Science and Technology Bureau 2021AD30117
6 · The paper itself

Abstract

backgroundThe surgical methods for periprosthetic distal femoral fractures (PDFFs) after total knee arthroplasty included locking compression plate (LCP), retrograde intramedullary nailing (RIMN), and distal femoral replacement (DFR). However, the optimal treatment remains controversial. We performed a network meta-analysis (NMA) to provide the optimal surgical method for PDFFs. MATERIALS AND

methodsElectronic databases, including Embase, Web of Science, Cochrane Library, and PubMed, were searched for studies that compared LCP, RIMN, and DFR for PDFFs. The quality of the included studies was assessed according to the Newcastle-Ottawa scale. Pairwise meta-analysis was performed by Review Manager version 5.4. The NMA was conducted in Aggregate Data Drug Information System software version 1.16.5. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for postoperative complications and reoperations.

resultsA total of 19 studies and 1198 patients were included, of whom 733 for LCP, 282 for RIMN, and 183 for DFR. Pairwise meta-analysis comparing LCP to RIMN and LCP to DFR showed no significant difference in complications and reoperations except that RIMN had a higher risk of malunion comparing to LCP (OR 3.05; 95% CI 1.46-6.34; P = 0.003). No statistically significant effects were found in the NMA of overall complications, infection, and reoperation. However, results of rank probabilities showed that DFR ranked best in overall complications and reoperation, RIMN ranked best in infection but worst in reoperation, and LCP ranked worst in infection and middle in reoperation. DISCUSSION: We found similar complication rate and reoperation rate between LCP, RIMN, and DFR. The results of rank probabilities favored DFR, and further studies with high-level evidence are expected to verify the optimal surgical method for PDFFs. LEVEL OF EVIDENCE: Level II; network meta-analysis.

Indexed as

Arthroplasty, Replacement, KneeFemoral FracturesFemoral Fractures, DistalPeriprosthetic FracturesBayes TheoremBone PlatesFracture Fixation, InternalHumansReoperationRetrospective StudiesTreatment OutcomeDistal femoral replacementLocking compression platePeriprosthetic fractureRetrograde intramedullary nailingTotal knee arthroplasty

Identifiers

PMID36803522
PMCPMC9942323
OpenAlexW4321369798

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.