Meta Analysis Of Lower Limb Force Lines In Total Knee Arthroplasty

Part?:Meta-analysis of curative effect After Navigated Total Knee Arthroplasty and Conventional Total KneeArthroplastyObjective Using the method of META analysis,To systematically evaluate the deviation of limb alignment and other results after knee arthroplasty by means of the navigation method and the traditional method,sum up the differences of curative effect and explore the safest and effective method for clinical work in the future.Method Using computer retrieved the randomized controlled clinical trials about the deviation of limb alignment on the coronal position after knee arthroplasty by means of the navigation method and traditional method.We extracted data including the deviation of limb alignment on the coronal position and the risk of implant malalignment at more than 3° and the risk of implant malalignment at more than ° and the deviation of femoral prosthesis coronal angle and the deviation of tibial prosthesis coronal angle and the operation time,Meta analysis was performed with stata 13.0 software.Results There were 15 clinical randomized controlled trials were included in this analysis,1281 cases of knee arthroplasty contained in the computer-assisted navigation group and 1367 cases of knee arthroplasty knees contained in the traditional group.The deviation of the limb alignment was greater than that in the navigation group[SMD=0.709,95%CI(0.407,1.012),P<0.001];the navigation group was more likely to control the limb alignment deviation within 2° than the traditional group[RR=1.427,95%CI(1.231,1.654),P<0.001];the navigation group was more likely to control the limb alignment deviation within 3° than the traditional group[RR=1.383,95%CI(1.109,1.725),P<0.001];the deviation of the femoral prosthesis coronal angle in the traditional group was greater than that in the navigation group[SMD=0.251,95%CI(0.001,0.501),P=0.049];the deviation of the tibial prosthesis coronal angle in the traditional group was greater than that in the navigation group[SMD=0.305,95%CI(0.113,0.497),P=0.002];the operation time of the traditional group was less than that of the navigation group[SMD=-1.232,95%CI(-1.566,-0.898),P<0.001].Conclusion Knee arthroplasty with computer navigation technology can bring more accurate limb alignment,but the operation time was significantly longer than that of the traditional group,the safety of operation is lower than that of traditional knee arthroplasty.Part II:Meta-analysis about relationship between Clinical results of artificial knee joint and postoperative mechanical axis after knee arthroplastyObjective Using the method of META analysis,To systematically evaluate the relationship between the postoperative mechanical axis and the clinical results of after knee arthro-plasty,Sum up the differences of curative effect and explore the safesst and effective method for clinical work in the future.Method Using computer retrieved the cohort studys about the Clinical results and deviation of postoperative mechanical axis.We extracted data including long-term joint revision rate and range of motion and HSS score of the artificial knee joint in two groups,one controled the deviation of postoperative mechanical axis within 3° and another controled the deviation of postoperative mechanical axis beyond 3°,Meta analysis was performed with stata 13.0 software.Results There were 6 cohort studys were included in this analysis,1085 persons in the group which controled the deviation of postoperative mechanical axis within 3°and 403 persons in the group which controled the deviation of postoperative mechanical axis beyond 3°.The long-term joint revision rate of the group which controled the deviation of postoperative mechanical axis within 3° was lower than another one[RR=0.569,95%CI(0.342,0.948),P=0 030];the range of joint motion was no difference between two groups[SWD=-0.084,95%CI(-0.263,0.095),P=0.357];the HSS score was no difference between two groups[SWD=0.362,95%CI(-0.471,1.194),P=0.394].Conclusion The postoperative mechanical axis after knee arthroplasty can reduce the long-term revision rate of the joint within 3°,but there is no sign-ificant improvement in range of joint motion and HSS score.