Evidence map›Paper›PMID 37864590›Full record

SynthesisArchives of orthopaedic and trauma surgery2024

Lateral versus medial approach for total knee arthroplasty for valgus knee deformity shows comparable functional outcomes, hip-knee-ankle angle values, and complication rates: a meta-analysis of comparative studies.

Michele Mercurio, Giorgio Gasparini, Olimpio Galasso, Filippo Familiari, Erminia Cofano, Valentina Sanzo, Gianluca Ciolli, Katia Corona, Simone Cerciello

Open access · hybridAbstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 1 pooled it
4.8field-weighted citation impact, top 4% 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

14 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Total knee arthroplasty in valgus knees achieves comparable outcomes to varus knees: a propensity score matched multicenter study.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 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

9 authors at 3 institutions in 1 country.

Michele MercurioDepartment of Orthopedic and Trauma Surgery, "Magna Græcia" University, "Mater Domini" University Hospital, V.Le Europa, 88100, Catanzaro, Italy.
Giorgio GaspariniDepartment of Orthopedic and Trauma Surgery, "Magna Græcia" University, "Mater Domini" University Hospital, V.Le Europa, 88100, Catanzaro, Italy.
Olimpio GalassoDepartment of Orthopedic and Trauma Surgery, "Magna Græcia" University, "Mater Domini" University Hospital, V.Le Europa, 88100, Catanzaro, Italy. galasso@unicz.it.ORCID http://orcid.org/0000-0002-4915-046X
Filippo FamiliariDepartment of Orthopedic and Trauma Surgery, "Magna Græcia" University, "Mater Domini" University Hospital, V.Le Europa, 88100, Catanzaro, Italy.
Erminia CofanoDepartment of Orthopedic and Trauma Surgery, "Magna Græcia" University, "Mater Domini" University Hospital, V.Le Europa, 88100, Catanzaro, Italy.
Valentina SanzoDepartment of Orthopedic and Trauma Surgery, "Magna Græcia" University, "Mater Domini" University Hospital, V.Le Europa, 88100, Catanzaro, Italy.
Gianluca CiolliDepartment of Orthopaedics, A. Gemelli University Hospital Foundation IRCCS, Catholic University, Rome, Italy.
Katia CoronaDepartment of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy.
Simone CercielloDepartment of Orthopaedics, A. Gemelli University Hospital Foundation IRCCS, Catholic University, Rome, Italy.
Magna Graecia University · ITAgostino Gemelli University Polyclinic · ITUniversity of Molise · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe aim of this meta-analysis of comparative studies was to update the current evidence on functional and radiographic outcomes and complications between medial and lateral approaches for total knee arthroplasty (TKA) for valgus knee deformity. MATERIALS AND

methodsThe PubMed, MEDLINE, Scopus, and the Cochrane Central databases were used to search keywords and a total of ten studies were included. The methodological quality of the included studies was assessed. Data extracted for quantitative analysis included the Knee Society score (KSS), range of motion (ROM), surgical time, hip-knee-ankle angle (HKA), and number and types of complications. Random- and fixed-effect models were used for the meta-analysis of pooled mean differences (MDs) and odds ratios (ORs). The Mantel-Haenszel method was adopted.

resultsA total of 1008 patients were identified, of whom 689 and 319 underwent TKA for valgus knee deformity with lateral and medial approach, respectively. The mean age was 70 ± 9.5 and 67.3 ± 9.6 years for the lateral and medial approaches, respectively. The mean follow-up was 37.8 ± 21.9 and 45.9 ± 26.7 months for the lateral and medial approach groups, respectively. Significantly higher functional outcomes were found for the medial approach, as measured by the postoperative KSS (MD = 1.8, 95% CI [0.48, 3.12], P = 0.007) and flexion ROM (MD = 3.12, 95% CI [0.45, 5.79], P = 0.02). However, both of these differences were lower than the minimal clinically important difference. Comparable surgical time and postoperative HKA angle values (MD = 0.22, 95% CI [- 0.30, 0.75], P = 0.40) between the two surgical approaches were found. The incidence of periprosthetic joint infections, fractures, transient peroneal nerve injuries, and deep vein thrombosis was comparable.

conclusionThis meta-analysis of comparative studies showed that when lateral and medial approaches are used for total knee arthroplasty for valgus knee deformity, comparable functional outcomes in terms of the KSS and ROM, surgical time, and postoperative hip-knee-ankle angle values can be expected. Similar rates of periprosthetic joint infection, fracture, and peroneal nerve injury were also found. LEVEL OF EVIDENCE: I. PROSPERO REGISTRATION NUMBER ID: CRD42023392807.

Indexed as

Arthroplasty, Replacement, KneeKnee ProsthesisOsteoarthritis, KneeAgedAnkleHumansKneeKnee JointMiddle AgedRange of Motion, ArticularRetrospective StudiesHip–knee–ankle angleKnee society scoreLateral approachMedial approachTotal knee arthroplastyValgus knee deformity

Identifiers

PMID37864590
PMCPMC10822808
OpenAlexW4387845517

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.