Should the patella be everted during primary total knee arthroplasty? A systematic review of overlapping meta-analyses. (18th February 2019)

• Record Type: Journal Article
• Authors: Grassi, Alberto; Compagnoni, Riccardo; Ferrua, Paolo; Pasqualotto, Stefano; Zaolino, Carlo; Zaffagnini, Stefano; Randelli, Pietro
• Is Part Of: Journal of orthopaedic surgery. Volume 27:Number 1(2019)
• Publication Date: 2019-02-18
• Subjects: arthroplasty -- eversion -- knee -- meta-analysis -- patella -- prosthesis -- TKA; Orthopedic surgery -- Periodicals; Orthopedics; Orthopedic surgery; Periodicals; 617.3
• DOI: 10.1177/2309499019828550
• Languages: English
• ISSNs: 1022-5536

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