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Patellar non-eversion in primary TKA reduces the complication rate

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study was designed to evaluate the isolated benefits of patellar non-eversion in total knee arthroplasty (TKA).

Methods

This systematic review and meta-analysis was conducted following the PRISMA statement. A comprehensive search of the MEDLINE/PubMed, Cochrane Library, and Embase databases was performed in August 2014. Randomized controlled trials (RCTs) that considered the handling of the patella as the only variable were included in our review. Quality assessment of RCTs was performed according to the CONSORT statement. The meta-analysis was performed to pool the available data for some parameters.

Results

The searches of the MEDLINE/PubMed, Cochrane Library, and Embase databases yielded 10 RCTs, and five RCTs were selected for inclusion in the review. This results suggested that tourniquet time [mean difference (MD) = −5.69; 95 % confidence interval (CI) −9.77 to −1.60], length of hospitalization (MD = 1.24; 95 % CI 0.54–1.94) and the incidence of complications [odds ratio (OR) = 2.23; 95 % CI 1.12–4.44] differed significantly between the eversion group and non-eversion group. No differences in postoperative pain, alignment, and the Insall–Salvati ratio were observed between the groups.

Conclusion

The patellar non-eversion approach offers a shorter length of hospitalization and lower incidence of postoperative complications, but requires more operative time. The merits of patellar non-eversion for recovery of knee function remain controversial, and more high-quality RCTs are needed to draw clear conclusions. In general, avoidance of patellar eversion is recommended when exposing the knee joint for TKA.

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Acknowledgments

The authors are pleased to acknowledge support from Professor Jing Tian. We are grateful for his enlightenment in the process of selecting the topic. Moreover, he took time from his busy schedule to give us valuable comments on a draft version of the paper. His instruction was of great help in the completion of our study.

Conflict of interest

The authors declare that they have no conflicts of interest.

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    Authors and Affiliations

    1. Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, 253 Industrial Avenue, Haizhu, Guangzhou, 510282, Guangdong, China

      Guangpu Yang, Wenfa Huang, Weixin Xie, Zhipeng Liu, Meimei Zheng, Yuxing Hu & Jing Tian

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    1. Guangpu Yang
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    2. Wenfa Huang
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    3. Weixin Xie
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    4. Zhipeng Liu
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    5. Meimei Zheng
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    6. Yuxing Hu
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    7. Jing Tian
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    Corresponding authors

    Correspondence to Guangpu Yang or Jing Tian.

    Additional information

    Guangpu Yang, Wenfa Huang, Weixin Xie, Zhipeng Liu, Meimei Zheng, Yuxing Hu, and Jing Tian have contributed equally to this paper.

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    Yang, G., Huang, W., Xie, W. et al. Patellar non-eversion in primary TKA reduces the complication rate. Knee Surg Sports Traumatol Arthrosc 24, 921–930 (2016). https://doi.org/10.1007/s00167-015-3528-5

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    • DOI: https://doi.org/10.1007/s00167-015-3528-5

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