Limb length discrepancy after total knee arthroplasty: A systematic review and meta-analysis  

作　　者：Sujit Kumar Tripathy Siddharth Satyakam Pradhan Paulson Varghese Prabhudev Prasad Purudappa Sandeep Velagada Tarun Goyal Bijnya Birajita Panda Jagadeesh Vanyambadi 

机构地区：[1]Department of Orthopaedics,All India Institute of Medical Sciences,Bhubaneswar 751019,Odisha,India [2]Department of Orthopedics,VA Boston Health care,Boston,Massachusetts 02130,United States [3]Department of Orthopaedics,All India Institute of Medical Sciences,Bathinda 209201,India [4]Department of Ophthalmology,SCB Medical College,Cuttack 751019,India [5]Department of Orthopaedics,Salford Royal NHS Foundation Trust,Salford M68HD,United Kingdom

出　　处：《World Journal of Clinical Cases》2021年第2期357-371,共15页世界临床病例杂志

摘　　要：BACKGROUND Limb length discrepancy(LLD)after total knee arthroplasty(TKA)has been considered as one of the reasons for the unsatisfactory outcome.However,there is no consensus about the extent of LLD that can be considered as clinically relevant.AIM To evaluate the incidence of radiographic LLD and its impact on functional outcome following TKA.METHODS All randomized-controlled trial and observational studies on LLD in TKA,published till 22nd June 2020,were systematically searched and reviewed.The primary outcome was“limb lengthening or LLD after TKA”.The secondary outcomes included“assessment of LLD in varus/valgus deformity”and“impact of LLD on the functional outcome”.RESULTS Of 45 retrieved studies,qualitative and quantitative assessment of data was performed from eight studies and six studies,respectively.Five studies(n=1551)reported the average limb lengthening of 5.98 mm.The LLD after TKA was ranging from 0.4±10 mm to 15.3±2.88 mm.The incidence of postoperative radiographic LLD was reported in 44%to 83.3%of patients.There was no difference in the preoperative and postoperative LLD(MD-1.23;95%CI:-3.72,1.27;P=0.34).Pooled data of two studies(n=219)revealed significant limb lengthening in valgus deformity than varus(MD-2.69;95%CI:-5.11,0.27;P=0.03).The pooled data of three studies(n=611)showed significantly worse functional outcome in patients with LLD of≥10 mm compared to<10 mm(standard MD 0.58;95%CI:0.06,1.10;P=0.03).CONCLUSION Limb lengthening after TKA is common,and it is significantly more in valgus than varus deformity.Significant LLD(≥10 mm)is associated with suboptimal functional outcome.

关 键 词：ARTHROPLASTY KNEE REPLACEMENT Limb length Joint diseases SURGERY 

分 类 号：R687.4[医药卫生—骨科学]