Meta-Analysis
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World J Meta-Anal. Nov 26, 2014; 2(4): 221-227
Published online Nov 26, 2014. doi: 10.13105/wjma.v2.i4.221
Female-specific vs conventional knee prostheses after total knee arthroplasty: A meta-analysis
Gen-Xiang Rong, Lei Huang, Bin-Jie Gui, A-Man Xu, Jing-Ling Zhang, Si-Sheng Wang
Gen-Xiang Rong, Bin-Jie Gui, Jing-Ling Zhang, Si-Sheng Wang, Department of Orthopedics, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
Lei Huang, A-Man Xu, Department of Gastrointestinal Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
Author contributions: Rong GX conceived and designed the review, conducted the statistical analyses and drafted the manuscript; Huang L, Gui BJ and Xu AM critically revised the manuscript and approved the final version of the manuscript submitted for publication; Zhang JL and Wang SS identified and acquired reports of trials and analyzed the data.
Correspondence to: Lei Huang, MD, Department of Gastrointestinal Surgery, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei 230022, Anhui Province, China. huangleizhenting@126.com
Telephone: +86-551-65334247 Fax: +86-551-63633742
Received: July 20, 2014
Revised: October 23, 2014
Accepted: October 28, 2014
Published online: November 26, 2014
Processing time: 134 Days and 14.6 Hours
Abstract

AIM: To study whether female-specific prostheses are superior to conventional prostheses after total knee arthroplasty (TKA) by conducting this meta-analysis to evaluate the effects of the 2 different designs.

METHODS: A systematic electronic search was conducted in the databases of PubMed, EMBASE and the Cochrane Library for prospective and retrospective trials. Meta-analysis was performed for the outcomes, including range of motion (ROM), Knee Society score, Hospital for Special Surgery scores (HSS) and complications including deep infection, manipulation under anesthesia (MUA), revisions, anterior knee pain, deep vein thrombosis and overhang rate. Meta-analysis was conducted where applicable. Weighted mean difference (WMD) and odds ratio were calculated according to study type.

RESULTS: Seven studies including 1174 knees were eligible for data extraction and pooled analysis. The overhang rate of female-specific prostheses was significantly lower than the conventional ones (WMD, 3.25; 95%CI: 0.00-0.27; P = 0.001). ROM in the female-specific prostheses group after TKA tended to be greater than the conventional prostheses group; however, with insignificant difference (WMD, 2.48; 95%CI: -0.83-5.78; P = 0.14). HSS (WMD, 0.48; 95%CI: -1.45-0.88; P = 0.63) and complications including deep infection (WMD, 0.39; 95%CI: 0.19-3.08; P =0 .70), MUA (WMD, 1.53; 95%CI: 0.02-1.61; P = 0.13) and revisions (WMD, 0.55; 95%CI: 0.07-4.34; P = 0.13) were all comparable between the two groups with at least 1 year follow-up. Other indexes were revealed to be similar between the two treatments with a descriptive analytical method.

CONCLUSION: Although the overhang rate is lower with female-specific prostheses, the current evidence does not support that female-specific prostheses outweigh conventional ones after TKA.

Keywords: Total knee arthroplasty; Female-specific; Conventional; Prosthesis; Meta-analysis

Core tip: In this meta-analysis, we systematically reviewed the literature and evaluated the clinical efficacy of female-specific vs conventional prostheses after total knee arthroplasty (TKA). We found that although the overhang rate is lower with female-specific prostheses and range of motion in the female-specific prostheses group tended to be greater than the conventional prostheses group, the current evidence does not support that female-specific prostheses are superior to conventional ones after TKA with all other parameters, including Knee Society score, Hospital for Special Surgery scores and complications including deep infection, manipulation under anesthesia, revisions, anterior knee pain and deep vein thrombosis comparable between the two treatments.