Effect of femoral posterior condyle offset on knee joint function after total knee replacement: a network meta-analysis and a sequential retrospective cohort study

Yimin Zhang,Yun Xu,Jun Wang,Miao Zhang

doi:10.1186/s13018-021-02233-8

Yimin Zhang, Yun Xu + Show 2 more

Open Access

https://doi.org/10.1186/s13018-021-02233-8

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Abstract

BackgroundThis study was conducted with the aim to compare the effect of posterior condyle offset (PCO) changes on knee joint function of patients following total knee replacement (TKR).MethodsElectronic and manual searches were performed in the PubMed, Embase, and Cochrane Library databases from inception to September 2019. Network meta-analysis combined direct and indirect evidence to assess the weighted mean difference (WMD) and surface under the cumulative ranking curves (SUCRA) of different PCO changes (PCO ≤ − 2 mm, − 2 mm < PCO < 0 mm, 0 mm ≤ PCO < 2 mm and PCO ≥ 2 mm) on knee joint function after TKR. Then 103 OA patients undergoing unilateral TKR were included and the effect of PCO on the postoperative knee function was examined.ResultsTotally, 5 cohort studies meeting the inclusion criteria were enrolled in this analysis. The results of meta-analysis showed that patients with 0 mm ≤ PCO < 2 mm after TKR had a better recovery of joint function (flexion contracture: 28.67%; KS functional score: 78.67%; KS knee score: 75.00%) than the remaining three groups. However, the knee flexion (77.00%) of patients with PCO ≤ − 2 mm after TKR was superior to the other three groups. Retrospective study also revealed a significant correlation between PCO changes and the flexion contracture, further flexion and KS functional score of patients after TKR, in which each functional knee score of patients with 0 mm ≤ PCO < 2 mm was better than the others.ConclusionThese findings suggest a close correlation between PCO magnitude and knee joint function after TKR and that 0 mm ≤ PCO < 2 mm is superior to other changes for joint function after TKR.

Highlights

This study was conducted with the aim to compare the effect of posterior condyle offset (PCO) changes on knee joint function of patients following total knee replacement (TKR)
The results (Table 4) of surface under the cumulative ranking curves (SUCRA) of various interventions on the knee joint function post TKR showed that patients with 0 mm ≤ PCO < 2 mm after TKR had a better recovery of joint function than those with the remaining PCO changes
The direct evidence of pairwise meta-analysis showed that patients with 0 mm ≤ PCO < 2 mm had a better knee flexion improvement (WMD = 6.00, 95% CI = 2.49–9.50) following TKR

Summary

Introduction

This study was conducted with the aim to compare the effect of posterior condyle offset (PCO) changes on knee joint function of patients following total knee replacement (TKR). Osteoarthritis (OA) is a kind of joint degenerative disease and often results in serious pains and loss of joint function, mainly afflicting the middle-aged and elderly population [1, 2]. The incidence and prevalence of OA are increasing possibly attributed to the age, sex, obesity, and genetics of the population as well as abnormal loading of joints [4]. It has been shown to contribute to a greater improvement in the pains, knee function, and quality of life in patients with late-stage knee OA [8]. TKR fails to restore the full range of motion of the knee joint [9], that is to say, the motion range of the knee joint post TKR is an important factor to determine the postoperative function of patients [10]

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Conclusion