Retention versus sacrifice of the posterior cruciate ligament in total knee replacement for treatment of osteoarthritis and rheumatoid arthritis

Wilco Jacobs; Darren J Clement; Ate AB Wymenga

doi:10.1002/14651858.CD004803.pub2

Scolaris Content Display Scolaris Content Display

Contenido relacionado

Ir a:

Revisiones y protocolos relacionados
Guías
Temas

Revisiones y protocolos relacionados

Topics

Temas

Analysis 1.1

Comparison 1 Posterior cruciate retention vs Sacrifice (all types), Outcome 1 Range of motion.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.2

Comparison 1 Posterior cruciate retention vs Sacrifice (all types), Outcome 2 Flexion angle.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.3

Comparison 1 Posterior cruciate retention vs Sacrifice (all types), Outcome 3 Extension angle.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.4

Comparison 1 Posterior cruciate retention vs Sacrifice (all types), Outcome 4 Roll‐Back.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.5

Comparison 1 Posterior cruciate retention vs Sacrifice (all types), Outcome 5 Improvement of ROM.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.6

Comparison 1 Posterior cruciate retention vs Sacrifice (all types), Outcome 6 Knee Society Clinical score.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.7

Comparison 1 Posterior cruciate retention vs Sacrifice (all types), Outcome 7 Knee Society Function Score.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.8

Comparison 1 Posterior cruciate retention vs Sacrifice (all types), Outcome 8 Hospital Special Surgery Score.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.9

Comparison 1 Posterior cruciate retention vs Sacrifice (all types), Outcome 9 HSS Pain.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.10

Comparison 1 Posterior cruciate retention vs Sacrifice (all types), Outcome 10 HSS Muscle power.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.11

Comparison 1 Posterior cruciate retention vs Sacrifice (all types), Outcome 11 Loosening.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.12

Comparison 1 Posterior cruciate retention vs Sacrifice (all types), Outcome 12 Joint line.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.13

Comparison 1 Posterior cruciate retention vs Sacrifice (all types), Outcome 13 Clinical score.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.1

Comparison 2 Posterior cruciate retention vs Sacrifice (same prosthesis), Outcome 1 Range of motion.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.2

Comparison 2 Posterior cruciate retention vs Sacrifice (same prosthesis), Outcome 2 Improvement of ROM.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.1

Comparison 3 Posterior cruciate retention vs sacrifice (PS), Outcome 1 Range of motion.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.2

Comparison 3 Posterior cruciate retention vs sacrifice (PS), Outcome 2 Improvement of ROM.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Table 1. Search strategy

Dimension	Search strings
Diagnosis	Posterior cruciate ligament[MH] Cruciate[TW] PCL[TW] Gonarthrosis[TW] Osteoarthritis[TW] Rheuma[TW] "Arthritis, Rheumatoid"[MH] Arthrosis[TW] arthrit[TW] Arthritis[MH]
Treatment	"Knee replacement"[TW] Arthroplasty[TW] Prosthesis[TW] Prostheses[TW] Endoprosthesis[TW] Endoprostheses[TW] Implant[TW] Prostheses and implants[MH] Prosthesis implantation[MH]
Study design	RANDOMIZED‐CONTROLLED TRIAL[PT] RANDOMIZED‐CONTROLLED‐TRIALS[TW] "Controlled Clinical Trial"[PT] RANDOM‐ALLOCATION[TW] DOUBLE‐BLIND‐METHOD[TW] SINGLE‐BLIND‐METHOD[TW] CLINICAL‐TRIAL[PT] random[TW] RESEARCH DESIGN[MH] "Multicentre study"[TW] "Multicenter study"[PT] "Review, Multicase"[PT] trial(TW) "Random allocation"[MH] Controlled[TW] Prospective[TW] "Prospective studies"[MH]

Table 1. Search strategy

Ir a la tabla de la revisión

Table 2. Methodological criteria

	Aspect	Description	van tulder Item
Van Tulder	Randomisation	Is a valid randomisation technique applied?	A
	Allocation concealment	Was the treatment allocation concealed?	B
	prognostic factors	Are the patient groups comparable on prognostic factors?	C
	Patient blinding	Is the patient blinded for the treatment allocation?	D
	Surgeon blinding	Is the surgeon blinded for the treatment allocation?	E
	Outcome assessor blinding	Is the outcome assessor blinded for the treatment allocation?	F
	Co‐interventions	Are the co‐interventions described in sufficient detail?	G
	Compliance	Is the compliance acceptable?	H
	Drop‐out	Is the drop‐out rate given and acceptable?	I
	Timing	Is the timing of the outcome assesments comparable between groups and consistent within groups?	J
	Intention to treat	Is an intention to treat analysis given?	K
Homogeneity	Homogeneity	Is the patient group homogeneous on prognostic factors	‐
	Homogeneous subgroups	If the total group is not homogeneous, are there subgroups given which are homogeneous?‐	‐
Jadad Checklist	Randomisation	Was the study described as randomised?	‐
		Was the method of randomisation described and appropriate?	‐
	Blinding	Was the study described as double blind?	‐
		Was the method of blinding described and appropriate?	‐
	Lost patients	Was there a description of withdrawals and dropouts?	‐
Clinical relevance		Are the patients described in detail so that you can decide whether they are comparable to those that you see in your practice?	‐
		Are the interventions and treatment settings described well enough so that you can provide the same for your patients?	‐
		Were all clinically relevant outcomes measured and reported?	‐
		Is the size of the effect clinically important?	‐
		Are the likely treatment benefits worth the potential harms?	‐

Table 2. Methodological criteria

Ir a la tabla de la revisión

Table 3. Methodological Quality (van Tulder)

Study	A, B	C	D, E, F	G	H	I	J	K
Catani 2004	?, ?	Yes	?, ?, ?	No	Yes	Yes	Yes	Yes
Clark 2001	?, ?	Yes	?, No, ?	Yes	Yes	No	Yes	?
Maruyama 2004	?, ?	?	No, No, No	No	Yes	Yes	Yes	Yes
Misra 2003	Yes, No	Yes	?, No, Yes	No	Yes	No	Yes	?
Shoji 1994	?, ?	?	?, No, ?	No	?	Yes	No	Yes
Straw 2003	?, ?	Yes	No, No, Yes	Yes	No	No	?	?
Swanik 2004	Yes, ?	?	Yes, No, Yes	No	Yes	Yes	?	Yes
Tanzer 2002	?, ?	Yes	Yes, No, Yes	Yes	Yes	Yes	Yes	Yes
Legend ‐ see Additional Table 02

Table 3. Methodological Quality (van Tulder)

Ir a la tabla de la revisión

Table 4. Methodological Quality (Jadad)

Study	Descr as Randomised?	Valid Randomisation?	Described as Blinded	Valid blinding?	Withdr And dropouts?
Catani 2004	Yes	No	No	NA	Yes
Clark 2001	Yes	No	No	NA	No
Maruyama 2004	Yes	No	No	NA	No
Misra 2003	Yes	Yes	No	NA	Yes
Shoji 1994	Yes	No	No	NA	No
Straw 2003	Yes	No	No	NA	Yes
Swanik 2004	Yes	Yes	No	NA	No
Tanzer 2002	Yes	No	Yes	Unsure	Yes

Table 4. Methodological Quality (Jadad)

Ir a la tabla de la revisión

Table 5. Complications

Study	Complications PCR	Complications PCS/PS
Catani 2004	1 lateral release and patella resurfacing for anterior knee pain, 1 manipulation for limited ROM	2 lateral release and patella resurfacing for anterior knee pain
Clark 2001	Not reported	Not reported
Maruyama 2004	None	1 Superficial wound infection
Misra 2003	3 instability, 1 infection, 2 aseptic loosening, 2 stiffness	3 instability, 3 aseptic loosening, 2 stiffness, 1 reflex sympathetic dystrophy
Shoji 1994	Not reported	Not reported
Straw 2003	Not reported	Not reported
Swanik 2004	Not reported	Not reported
Tanzer 2002	No revisions or migration, non‐progressive radiolucencies in 3 patella, 1 tibial and 1 femoral component	No revisions or migration, non‐progressive radiolucencies in 2 patella, 2 tibial and 4 femoral component

Table 5. Complications

Ir a la tabla de la revisión

Table 6. Assessment of clincial relevance

Study	Description patients	Intervention described	Outcome measures	Effect size	Benefits / harms
	Are the patients described in detail so that you can decide whether they are comparable to those that you see in your practice?	Are the interventions and treatment settings described well enough so that you can provide the same for your patients?	Were all clinically relevant outcomes measured and reported?	Is the size of the effect clinically important?	Are the likely treatment benefits worth the potential harms?
Catani 2004	No	No	No	Unsure	Unsure
Clark 2001	No	Yes	No	No	Unsure
Maruyama 2004	Yes	no	no	Yes	Yes
Misra 2003	No	No	No	No	Unsure
Shoji 1994	No	No	No	No	Unsure
Straw 2003	No	No	No	No	Unsure
Swanik 2004	Yes	No	No	No	Unsure
Tanzer 2002	Yes	Yes	No	No	Unsure

Table 6. Assessment of clincial relevance

Ir a la tabla de la revisión

Comparison 1. Posterior cruciate retention vs Sacrifice (all types)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Range of motion Show forest plot	6	540	Mean Difference (IV, Random, 95% CI)	‐4.38 [‐8.60, ‐0.16]

2 Flexion angle Show forest plot	2	60	Mean Difference (IV, Fixed, 95% CI)	‐2.53 [‐9.15, 4.08]

3 Extension angle Show forest plot	1	20	Mean Difference (IV, Random, 95% CI)	‐0.60 [‐2.08, 0.88]

4 Roll‐Back Show forest plot	1	105	Risk Ratio (M‐H, Random, 95% CI)	0.90 [0.44, 1.81]

5 Improvement of ROM Show forest plot	4	309	Mean Difference (IV, Fixed, 95% CI)	0.93 [‐4.75, 6.60]

6 Knee Society Clinical score Show forest plot	4	291	Mean Difference (IV, Fixed, 95% CI)	0.52 [‐1.71, 2.75]

7 Knee Society Function Score Show forest plot	3	271	Mean Difference (IV, Fixed, 95% CI)	‐3.55 [‐8.71, 1.61]

8 Hospital Special Surgery Score Show forest plot	3	201	Mean Difference (IV, Fixed, 95% CI)	‐1.64 [‐3.13, ‐0.14]

9 HSS Pain Show forest plot	1	56	Mean Difference (IV, Random, 95% CI)	‐0.20 [‐1.54, 1.14]

10 HSS Muscle power Show forest plot	1	56	Mean Difference (IV, Random, 95% CI)	0.30 [‐0.36, 0.96]

11 Loosening Show forest plot	1	105	Risk Ratio (M‐H, Random, 95% CI)	1.06 [0.22, 5.01]

12 Joint line Show forest plot	1	34	Mean Difference (IV, Random, 95% CI)	20.6 [18.49, 22.71]

13 Clinical score Show forest plot	5	412	Std. Mean Difference (IV, Fixed, 95% CI)	‐0.03 [‐0.23, 0.16]

Comparison 1. Posterior cruciate retention vs Sacrifice (all types)

Ir a la tabla de la revisión

Comparison 2. Posterior cruciate retention vs Sacrifice (same prosthesis)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Range of motion Show forest plot	3	286	Mean Difference (IV, Random, 95% CI)	‐3.69 [‐10.78, 3.41]

2 Improvement of ROM Show forest plot	2	161	Mean Difference (IV, Fixed, 95% CI)	2.02 [‐5.82, 9.86]

Comparison 2. Posterior cruciate retention vs Sacrifice (same prosthesis)

Ir a la tabla de la revisión

Comparison 3. Posterior cruciate retention vs sacrifice (PS)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Range of motion Show forest plot	4	296	Mean Difference (IV, Random, 95% CI)	‐8.07 [‐14.49, ‐1.66]

2 Improvement of ROM Show forest plot	2	148	Mean Difference (IV, Fixed, 95% CI)	‐0.27 [‐8.50, 7.96]

Comparison 3. Posterior cruciate retention vs sacrifice (PS)

Ir a la tabla de la revisión

The Cochrane Library

Scolaris Language Selector Scolaris Language Selector

Idioma de la Revisión Cochrane

Idioma de la web

Scolaris Content Language Banner Portlet Scolaris Content Language Banner Portlet