PURPOSE: Total knee arthroplasty (TKA) as a treatment for end-stage osteoarthritis of the knee shows good results in terms of patient satisfaction. For the assessment of outcome and revision rate after total joint arthroplasty, there are two major data sources: clinical studies and national arthroplasty registers. The purpose of this study was to analyse the outcome of Anatomic Graduated Component (AGC) TKA reported in clinical studies and to perform a comparison with the outcome reported by national arthroplasty registers. METHODS: A systematic literature review was performed using standardised methodology in order to determine the outcome and revision rate of AGC TKA. In a comprehensive meta-analysis of clinical studies and worldwide register results we examined the quality of the basic data and the occurrence and influence of potential bias factors. Confidence intervals were calculated to determine the statistical significance of differences. RESULTS: We found significant differences as regards the revision rate measured in revisions per 100 observed component years. Compared to worldwide register data it turned out to be significantly lower in clinical studies published by the implant development team. Actually, they reported a revision rate of 0.18 revisions per 100 observed component years, whereas annual reports of national arthroplasty registers report 0.74 revisions per 100 observed component years. A comparison of the results from national arthroplasty registers of different countries revealed a significantly higher revision rate for Denmark in relation to worldwide register data. CONCLUSIONS: A conventional meta-analysis of clinical studies is affected by the influence of the development team and therefore subject to bias. For the assessment of outcome arthroplasty register data should be rated as superior and, being used as reference data for the detection of potential bias factors in the clinical literature, could make an essential contribution to the quality of scientific meta-analysis.
PURPOSE:Total knee arthroplasty (TKA) as a treatment for end-stage osteoarthritis of the knee shows good results in terms of patient satisfaction. For the assessment of outcome and revision rate after total joint arthroplasty, there are two major data sources: clinical studies and national arthroplasty registers. The purpose of this study was to analyse the outcome of Anatomic Graduated Component (AGC) TKA reported in clinical studies and to perform a comparison with the outcome reported by national arthroplasty registers. METHODS: A systematic literature review was performed using standardised methodology in order to determine the outcome and revision rate of AGC TKA. In a comprehensive meta-analysis of clinical studies and worldwide register results we examined the quality of the basic data and the occurrence and influence of potential bias factors. Confidence intervals were calculated to determine the statistical significance of differences. RESULTS: We found significant differences as regards the revision rate measured in revisions per 100 observed component years. Compared to worldwide register data it turned out to be significantly lower in clinical studies published by the implant development team. Actually, they reported a revision rate of 0.18 revisions per 100 observed component years, whereas annual reports of national arthroplasty registers report 0.74 revisions per 100 observed component years. A comparison of the results from national arthroplasty registers of different countries revealed a significantly higher revision rate for Denmark in relation to worldwide register data. CONCLUSIONS: A conventional meta-analysis of clinical studies is affected by the influence of the development team and therefore subject to bias. For the assessment of outcome arthroplasty register data should be rated as superior and, being used as reference data for the detection of potential bias factors in the clinical literature, could make an essential contribution to the quality of scientific meta-analysis.
Authors: Philip M Faris; Merrill A Ritter; E Michael Keating; John B Meding; Leesa D Harty Journal: J Bone Joint Surg Am Date: 2003-03 Impact factor: 5.284
Authors: M A Ritter; R Worland; J Saliski; J V Helphenstine; K L Edmondson; E M Keating; P M Faris; J B Meding Journal: Clin Orthop Relat Res Date: 1995-12 Impact factor: 4.176
Authors: Richard L Worland; Gonzalo Vazquez-Vela Johnson; Jose Alemparte; Douglas E Jessup; Jonathan Keenan; Nelson Norambuena; Gonzalo Johnson Journal: Knee Date: 2002-05 Impact factor: 2.199
Authors: A J Price; J L Rees; D Beard; E Juszczak; S Carter; S White; R de Steiger; C A F Dodd; M Gibbons; P McLardy-Smith; J W Goodfellow; D W Murray Journal: J Bone Joint Surg Br Date: 2003-01
Authors: Ulrike Wittig; Maximilian Moshammer; Ines Vielgut; Georg Hauer; Patrick Reinbacher; Andreas Leithner; Patrick Sadoghi Journal: Arch Orthop Trauma Surg Date: 2022-03-18 Impact factor: 3.067
Authors: M G M Schotanus; P Pilot; B L Kaptein; W F Draijer; P B J Tilman; R Vos; N P Kort Journal: Knee Surg Sports Traumatol Arthrosc Date: 2016-04-27 Impact factor: 4.342
Authors: Patrick Sadoghi; Christian Schröder; Andreas Fottner; Arnd Steinbrück; Oliver Betz; Peter E Müller; Volkmar Jansson; Andreas Hölzer Journal: Int Orthop Date: 2012-08-23 Impact factor: 3.075