Evidence map›Paper›PMID 36939891›Full record

Trial reportArchives of orthopaedic and trauma surgery2023

Restoring tibial obliquity for kinematic alignment in total knee arthroplasty: conventional versus patient-specific instrumentation.

Maria Anna Smolle, Amir Koutp, Clemens Clar, Lukas Leitner, Andreas Leithner, Patrick Sadoghi

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
  2. 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

6 authors.

Maria Anna SmolleDepartment of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria.
Amir KoutpDepartment of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria.
Clemens ClarDepartment of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria.
Lukas LeitnerDepartment of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria.
Andreas LeithnerDepartment of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria.
Patrick SadoghiDepartment of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria. Patrick.sadoghi@medunigraz.at.ORCID http://orcid.org/0000-0003-0786-8956

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIn total knee arthroplasty (TKA), tibial obliquity-restoration using kinematic alignment (KA) poses a major difference to conventional mechanical alignment. This study aimed at analysing the accuracy of conventional instrumentation (CI) versus patient-specific instrumentation (PSI) to restore anatomic tibial obliquity measured by the medial proximal tibial angle (MPTA) on conventional X-rays. MATERIALS AND

methodsOne-hundred patients were randomized to receive CI (n = 50) or PSI (n = 50) for TKA. Further 100 patients received CI without randomisation, resulting in 200 patients in total (127 women, mean age: 70.7 (range: 48-90 years). Pre- and postoperative X-rays were measured twice by two observers with a 2-week break in-between. Inter- and intraclass correlations were calculated and postoperative tibial obliquity compared to preoperative anatomy.

resultsIn 150 patients with CI, no case with tibial obliquity-deviation greater than 2° was found, whilst 21.3% (n = 32) and 0.7% (n = 1) of cases and had a deviation of 0°-1°, and 1°-2°, respectively. In the remaining 78.0% (n = 117), tibial obliquity was restored. In 50 patients with PSI, no single case with a deviation greater than 1° was found. Sixty percent (n = 30) had a deviation of 0°-1°. In the remaining 40.0% (n = 20), no deviation from preoperative measurements was found. Consequently, CI resulted in a significantly smaller change in tibial obliquity from preoperative to postoperative than PSI (p < 0.001). Inter- and intra-class correlations showed a substantial agreement (any ICC > 0.90).

conclusionBoth conventional and patient-specific instrumentation revealed adequate results with respect to restoring tibial obliquity in kinematically aligned TKA, with conventional instrumentation achieving superior results.

Indexed as

Arthroplasty, Replacement, KneeKnee ProsthesisOsteoarthritis, KneeAgedBiomechanical PhenomenaFemaleHumansKnee JointRadiographyTibiaConventional instrumentationKinematic alignmentPatient-specific instrumentationTibial obliquityTotal knee arthroplasty

Identifiers

PMID36939891
PMCPMC10449675

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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.