Mechanical versus kinematic alignment for total knee arthroplasty: a meta-analysis

IF 2.1 3区医学 Q2 ORTHOPEDICS Archives of Orthopaedic and Trauma Surgery Pub Date : 2025-03-25 DOI:10.1007/s00402-025-05835-7

Filippo Migliorini, Nicola Maffulli, Marco Pilone, Luise Schäfer, David Ullmann, Thorsten Huber, Björn Rath

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Abstract

Introduction

The present meta-analysis compared mechanical versus kinematic alignment in total knee arthroplasty (TKA). The outcomes of interest were patient-reported outcome measures (PROMs), range of motion (ROM), and revision rate.

Methods

This study was conducted according to the 2020 PRISMA statement. In July 2024, PubMed, Web of Science, Google Scholar, and Embase were accessed without time constraints. All the clinical studies that compared mechanical versus kinematic alignment in total knee arthroplasty were accessed.

Results

30 studies (3133 TKAs) were collected. The mean duration of the follow-up was 30.8 ± 38 months. No difference was found in Knee KSS-F, Knee Society Score (KSS, P = 0.2) and its function subscale (P = 0.3), visual analogue scale (VAS, P = 0.3), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC, P = 0.2), Oxford Knee Score (OKS, P = 0.5). No difference was found in the rate of revision (P = 0.4). The ROM was slightly greater in the kinematic group (P < 0.0001).

Conclusion

PROMs and revision did not show a difference between mechanical and kinematic alignment in TKA. However, a minimal difference in the ROM was evidenced, which probably does not have clinical relevance.

Level of evidence

Level IV, systematic review and meta-analysis.

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全膝关节置换术的机械对齐与运动对齐：一项荟萃分析

本荟萃分析比较了全膝关节置换术（TKA）中的机械对齐与运动学对齐。感兴趣的结果是患者报告的结果测量（PROMs），活动范围（ROM）和修正率。方法本研究按照2020年PRISMA声明进行。2024年7月，PubMed、Web of Science、b谷歌Scholar和Embase在没有时间限制的情况下被访问。所有比较全膝关节置换术中机械对齐与运动学对齐的临床研究均被获取。结果共收集到30项研究（3133例tka）。平均随访时间30.8±38个月。膝关节KSS- f、膝关节社会评分（KSS, P = 0.2）及其功能子量表（P = 0.3）、视觉模拟评分（VAS, P = 0.3）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC, P = 0.2）、牛津膝关节评分（OKS, P = 0.5）均无差异。修正率无差异（P = 0.4）。运动组的ROM略大（P < 0.0001）。结论在TKA中，机械对齐和运动对齐在力学对齐和运动对齐方面没有差异。然而，ROM的微小差异被证实，这可能没有临床相关性。证据水平：四级，系统评价和荟萃分析。

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来源期刊

Archives of Orthopaedic and Trauma Surgery 医学-外科

CiteScore

4.30

自引率

13.00%

发文量

424

审稿时长

2 months

期刊介绍： "Archives of Orthopaedic and Trauma Surgery" is a rich source of instruction and information for physicians in clinical practice and research in the extensive field of orthopaedics and traumatology. The journal publishes papers that deal with diseases and injuries of the musculoskeletal system from all fields and aspects of medicine. The journal is particularly interested in papers that satisfy the information needs of orthopaedic clinicians and practitioners. The journal places special emphasis on clinical relevance. "Archives of Orthopaedic and Trauma Surgery" is the official journal of the German Speaking Arthroscopy Association (AGA).