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No difference in clinical outcome between patella eversion and lateral retraction in total knee arthroplasty: a systemic review and meta-analysis

Knee Surgery, Sports Traumatology, Arthroscopy volume 23, pages 1791–1798 (2015)Cite this article

Abstract

Purpose

Surgical exposure during total knee arthroplasty (TKA) requires mobilization technique of the patella. Proponents of minimally invasive TKA claim that lateral retraction, rather than eversion, of the patella may be beneficial. Many randomized controlled studies attempt to identify this issue; however, no final conclusion arrives. With this systemic review and meta-analysis, we intended to test whether patella eversion during TKA had deleterious effects.

Methods

A comprehensive literature search was performed in PubMed, MEDLINE, EMBASE and other internet database. We retrieved all the relevant studies designed to interpret this issue. The searching time frame was from the establishing of these databases until July 2014.

Results

Six randomized controlled trials assessing a total of 414 patients and 451 knees were included. The duration of surgery was much shorter (p = 0.003), and the length of skin incision was much longer (p < 0.00001). No significant difference was found on other measurements, including length of hospital stay, quadriceps strength, complications, straight leg raise, Visual Analogue Scale score and functional scores.

Conclusions

Patella eversion could decrease the duration of the surgery; nevertheless, the length of skin incision was longer; no significant difference was found on other measurements, especially the quadriceps strength and complications which were concerned. Patella eversion and patella lateral retraction could achieve similar clinical outcomes.

Level of evidence

Systematic review and meta-analysis, Level I.

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Authors and Affiliations

  1. Department of Orthopedics, Tongji University, Shanghai Tenth People’s Hospital, 301 Yanchang Rd, Shanghai, 200072, People’s Republic of China

    Pengfei Zan, Yong Yang, Xinyu Cai & Guodong Li

  2. Department of Orthopedics, Shanghai Jiao Tong University, Shanghai First People’s Hospital, Shanghai, People’s Republic of China

    Wei Sun & Xiaojun Ma

Authors
  1. Pengfei Zan
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  2. Wei Sun
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  3. Yong Yang
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  4. Xinyu Cai
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  5. Xiaojun Ma
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  6. Guodong Li
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Corresponding author

Correspondence to Guodong Li.

Additional information

Pengfei Zan and Wei Sun are co-first authors.

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Zan, P., Sun, W., Yang, Y. et al. No difference in clinical outcome between patella eversion and lateral retraction in total knee arthroplasty: a systemic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 23, 1791–1798 (2015). https://doi.org/10.1007/s00167-014-3477-4

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  • DOI: https://doi.org/10.1007/s00167-014-3477-4

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