The Knee
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Review Meta Analysis Comparative Study
Does cruciate-retaining total knee arthroplasty enhance knee flexion in Western and East Asian patient populations? A meta-analysis.
This study analyzed the published data to examine if CR TKAs can enhance the flexion and functional outcomes of the knee in the Western and East Asian populations using a meta-analysis approach. ⋯ The meta-analysis indicated that contemporary CR TKAs have not been shown to enhance post-operative flexion capability in the Western and East Asian. The extension angles of the knee and the knee scores were significantly improved in both populations.
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Review Meta Analysis
Topical tranexamic acid in total knee replacement: a systematic review and meta-analysis.
To examine the safety and efficacy of topical use of tranexamic acid (TA) in total knee arthroplasty (TKA). ⋯ I, II.
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The objective of this study was to evaluate the effectiveness of hamstring (HT) autografts versus bone-patellar tendon-bone (BPTB) autografts for reconstruction of the anterior cruciate ligament (ACL). We searched the Cochrane Library, MEDLINE, EMBASE and the Chinese Biomedicine Database (CBM) for published randomised clinical trials (RCTs) relevant to ACL reconstruction comparing HT and BPTB autografts. Data analyses were performed with Cochrane Collaboration's RevMan 5.0. ⋯ Outcome measures that favoured HT autografts included anterior knee pain, kneeling pain and extension loss. There was no statistical difference of postoperative graft failure. Overall, postoperative complications of the knee joint were lower for HT autografts than for BPTB autografts, and BPTB autografts were superior to HT autografts in resuming stability of the knee joint, but four-strand HT combined with application of the modern endobutton HT graft-fixation technique could increase knee-joint stability.
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Review Meta Analysis
Is a tourniquet beneficial in total knee replacement surgery? A meta-analysis and systematic review.
Proponents of tourniquets postulate that they optimise intra-operative visibility and reduce blood loss. This study compared the outcomes of tourniquet assisted to non-tourniquet assisted total knee replacement (TKR). A systematic review was undertaken of the electronic databases Medline, CINAHL, AMED and EMBASE, in addition to a review of unpublished material and a hand search of pertinent orthopaedic journals. ⋯ There was a trend for greater complications in tourniquet compared to non-tourniquet patients. There was no difference between the groups for any other outcome measure assessed. In conclusion, this systematic review has found that there is no advantage to using a tourniquet in knee replacement surgery for reduction of transfusion requirements.