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Abstract：
UNASSIGNED: Computer-assisted navigation surgery (CAS) during primary total knee arthroplasty (TKA) may help improve outcomes for patients with extra-articular deformity (EAD); however, this has not been extensively studied. Therefore, we aimed to investigate the clinical and radiological outcomes following primary TKA using CAS in patients with EAD.
UNASSIGNED: We searched Medline, Embase, and the Cochrane Library up to March 3, 2023 for studies investigating surgical outcomes of using the navigation system for TKA to treat patients with EAD. From 14 studies, 539 knees with EAD that underwent navigation TKA were enrolled. We investigated the knee range of motion (ROM), outcome scores at final follow-up (Knee Society Score [KSS] and Knee Functional Score [KFS]), and pre- and postoperative mechanical hip-knee-ankle (mHKA) angle using lower extremity scanogram. The meta-analysis was based on the single-arm method, and all data were pooled using a random-effects model.
UNASSIGNED: Following our meta-analyses, the mean knee ROM changed from 87.0° (95% confidence interval [CI], 75.9°-98.1°) preoperatively to 109.4° (95% CI, 97.9°-120.8°) postoperatively. The adjusted KSS was 93.45 points (95% CI, 88.36-98.54 points), and the adjusted KFS was 91.57 points (95% CI, 86.80-96.33 points) in knees with EAD that underwent CAS-TKA. As a radiological outcome, the mHKA angle changed from 169.53° (95% CI, 166.90°-172.16°) preoperatively to 178.81° (95% CI, 178.31°-179.30°) postoperatively.
UNASSIGNED: CAS-TKA yielded positive clinical results and demonstrated a satisfactory alignment of the lower limb\'s mechanical axis. CAS-TKA showed promise for primary TKA procedures, demonstrating favorable clinical and radiological outcomes even in complex cases involving EAD.
UNASSIGNED: We searched Medline, Embase, and the Cochrane Library up to March 3, 2023 for studies investigating surgical outcomes of using the navigation system for TKA to treat patients with EAD. From 14 studies, 539 knees with EAD that underwent navigation TKA were enrolled. We investigated the knee range of motion (ROM), outcome scores at final follow-up (Knee Society Score [KSS] and Knee Functional Score [KFS]), and pre- and postoperative mechanical hip-knee-ankle (mHKA) angle using lower extremity scanogram. The meta-analysis was based on the single-arm method, and all data were pooled using a random-effects model.
UNASSIGNED: Following our meta-analyses, the mean knee ROM changed from 87.0° (95% confidence interval [CI], 75.9°-98.1°) preoperatively to 109.4° (95% CI, 97.9°-120.8°) postoperatively. The adjusted KSS was 93.45 points (95% CI, 88.36-98.54 points), and the adjusted KFS was 91.57 points (95% CI, 86.80-96.33 points) in knees with EAD that underwent CAS-TKA. As a radiological outcome, the mHKA angle changed from 169.53° (95% CI, 166.90°-172.16°) preoperatively to 178.81° (95% CI, 178.31°-179.30°) postoperatively.
UNASSIGNED: CAS-TKA yielded positive clinical results and demonstrated a satisfactory alignment of the lower limb\'s mechanical axis. CAS-TKA showed promise for primary TKA procedures, demonstrating favorable clinical and radiological outcomes even in complex cases involving EAD.
摘要：
■初次全膝关节置换术（TKA）期间的计算机辅助导航手术（CAS）可能有助于改善关节外畸形（EAD）患者的预后；然而，这还没有得到广泛的研究。因此,我们旨在研究EAD患者使用CAS进行初次TKA后的临床和放射学结局.
■我们搜索了Medline，Embase,以及截至2023年3月3日的Cochrane图书馆，用于研究使用TKA导航系统治疗EAD患者的手术结果。从14项研究中，纳入539例接受导航TKA的EAD患者。我们研究了膝盖运动范围(ROM)，最终随访结果评分（膝关节社会评分[KSS]和膝关节功能评分[KFS]），使用下肢扫描图，术前和术后机械髋-膝-踝（mHKA）角度。荟萃分析基于单臂法，所有数据均使用随机效应模型进行汇总.
■在我们的荟萃分析之后，平均膝关节ROM从87.0°变化(95%置信区间[CI]，术前75.9°-98.1°）至术后109.4°（95％CI，97.9°-120.8°）。调整后的KSS为93.45点(95%CI，88.36-98.54点)，在接受CAS-TKA的EAD患者中，校正后的KFS为91.57分（95％CI，86.80-96.33分）。作为放射学结果，mHKA角度从术前169.53°（95％CI，166.90°-172.16°）变为术后178.81°（95％CI，178.31°-179.30°）。
■CAS-TKA取得了积极的临床结果，并显示出令人满意的下肢机械轴对准。CAS-TKA显示出主要TKA程序的希望，即使在涉及EAD的复杂病例中，也能证明良好的临床和放射学结果。
■我们搜索了Medline，Embase,以及截至2023年3月3日的Cochrane图书馆，用于研究使用TKA导航系统治疗EAD患者的手术结果。从14项研究中，纳入539例接受导航TKA的EAD患者。我们研究了膝盖运动范围(ROM)，最终随访结果评分（膝关节社会评分[KSS]和膝关节功能评分[KFS]），使用下肢扫描图，术前和术后机械髋-膝-踝（mHKA）角度。荟萃分析基于单臂法，所有数据均使用随机效应模型进行汇总.
■在我们的荟萃分析之后，平均膝关节ROM从87.0°变化(95%置信区间[CI]，术前75.9°-98.1°）至术后109.4°（95％CI，97.9°-120.8°）。调整后的KSS为93.45点(95%CI，88.36-98.54点)，在接受CAS-TKA的EAD患者中，校正后的KFS为91.57分（95％CI，86.80-96.33分）。作为放射学结果，mHKA角度从术前169.53°（95％CI，166.90°-172.16°）变为术后178.81°（95％CI，178.31°-179.30°）。
■CAS-TKA取得了积极的临床结果，并显示出令人满意的下肢机械轴对准。CAS-TKA显示出主要TKA程序的希望，即使在涉及EAD的复杂病例中，也能证明良好的临床和放射学结果。
