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Archives of Orthopaedic and Trauma Surgery

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01-09-2020 | Knee Arthroplasty

Gap balancing versus measured resection for primary total knee arthroplasty: a meta-analysis study

Authors: Filippo Migliorini, Jörg Eschweiler, Yasser El Mansy, Valentin Quack, Hanno Schenker, Markus Tingart, Arne Driessen

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 9/2020

Abstract

Introduction

To achieve the most desirable post-operative results, operation techniques and procedures for total knee arthroplasty (TKA) are highly standardized. However, debates persist whether patients having undergone a gap balancing technique (GB) perform better than those having undergone measured resection (MR) technique. Therefore, a meta-analysis study was conducted to investigate advantages of GB compared to the MR. The focus of the present study was on clinical and functional scores, radiological measurements and further complications.

Materials and methods

The present meta-analysis was conducted according to the PRISMA checklist. In November 2019, literature search was performed. All clinical studies comparing measured resection technique versus gap balancing technique for primary total knee arthroplasty were considered for inclusion. Only articles reporting quantitative data under the outcomes of interest were eligible for inclusion. The methodological quality assessment and statistical analyses were performed through the Review Manager Software version 5.3 (The Cochrane Collaboration, Copenhagen).

Results

Data from 25 clinical trials (2971 procedures) were collected. Patient baseline demonstrated a good comparability. No difference among the two cohorts was found in terms of SF-12 Mental and Physical, ROM, KSS, KSS Function, OKS, WOMAC. No difference was found in the alignment of mechanical axis and femoral rotation. During the knee motion, no difference was found between the medial and lateral gaps among the two techniques. The GB showed a significant elevated joint line (P < 0.0001), along with a longer duration of the operating time (P = 0.001). No differences were found in terms of revision surgery, aseptic loosening or prosthetic infections.

Conclusion

GB and MR achieve similar outcomes for TKA. In the GB group, a proximalisation of the joint line and extended operating time was detected. Regarding the additional outcomes of interest, the present analysis showed comparability between both groups, MR and GB.

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Title: Gap balancing versus measured resection for primary total knee arthroplasty: a meta-analysis study
Authors: Filippo Migliorini
Jörg Eschweiler
Yasser El Mansy
Valentin Quack
Hanno Schenker
Markus Tingart
Arne Driessen
Publication date: 01-09-2020
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 9/2020
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-020-03478-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Gap balancing versus measured resection for primary total knee arthroplasty: a meta-analysis study

Abstract

Introduction

Materials and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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