Should the patella be everted during primary total knee arthroplasty? A systematic review of overlapping meta-analyses

Alberto Grassi, Riccardo Compagnoni, Paolo Ferrua, Stefano Pasqualotto, Carlo Zaolino, Stefano Zaffagnini, Pietro Randelli

Research output: Contribution to journalArticle

Abstract

Patellar eversion during total knee arthroplasty (TKA) is a debated issue. The aim of this study is to perform a review of overlapping meta-analyses analyzing clinical outcomes of patellar eversion compared to noneversion. A search was performed in PubMed\MEDLINE, Scopus, and Cochrane Library. Inclusion criteria were meta-analysis of randomized controlled trials (RCTs) or quasi-RCTs;l comparison between TKAs with or without patellar eversion; and at least one outcome, such as reoperation rate, pain, and functional scores. Meta-analyses were evaluated with the A Measurement Tool to Assess Systematic Review (AMSTAR) score, addressing the most relevant one with the Jadad algorithm. Three meta-analyses were identified and included in this review. No significant differences were found regarding complications, quadriceps strength, functional, and radiological outcomes. The meta-analysis by Zan et al. was selected as the best available one. Patellar eversion group showed a shorter tourniquet time but a longer skin incision. In conclusion, eversion and noneversion techniques did not demonstrate any significant or clinically relevant difference. Level of Evidence: Level II, systematic review of meta-analyses.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalJournal of Orthopaedic Surgery
Volume27
Issue number1
DOIs
Publication statusPublished - Feb 20 2019

Keywords

  • TKA
  • arthroplasty
  • eversion
  • knee
  • meta-analysis
  • patella
  • prosthesis

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