Is high flexion total knee arthroplasty a rewarding procedure? An updated meta-analysis of prospective randomized controlled trials

• Published in: Archives of orthopaedic and trauma surgery 2021-05, Vol.141 (5), p.783-793
• Main Authors: Lei, Ting, Qian, Hu, Hua, Long, de Abreu e Silva, Guilherme Moreira, Hu, Yihe, Lei, Pengfei
• Format: Article
• Language: English
• Subjects: Clinical outcomes; Knee; Medicine; Medicine & Public Health; Meta-analysis; Orthopaedic Surgery; Orthopedics
• ISSN: 0936-8051; 1434-3916
• DOI: 10.1007/s00402-020-03481-9

Introduction The aim of this study is to provide an updated meta-analysis comparing the benefits and clinical outcomes between high flexion (HF)-TKA and standard (S)-TKA. Materials and methods A detailed database analysis was carried out using Web of Science, PubMed, EMBASE, Cochrane Library, MEDLINE and Clinicaltrial.gov, to identify eligible studies. The meta-analysis and sensitivity analysis were performed using Review Manager 5.3 software and STATA 12.0. Results Twenty-two randomized control trials (RCTs), including 2841 patients and 4268 knees, were eligible for the meta-analysis. The pooled results of subgroup analysis reveal that there was significant difference between HF-TKA and S-TKA in each subgroup in terms of postoperative ROM, with a higher degree of knee flexion for HF-TKA than S-TKA. However, no statistical difference was identified between HF-TKA and S-TKA in other clinical outcomes including various functional scores and complications. Conclusions On the basis of this meta-analysis, we can recommended HF-TKA as an alternative choice to S-TKA for patients requiring higher knee flexion in their daily activities.