1. Journal Club
Team A
29/01/2015

3. Principal research question
• Difference in clinical efficiency and
survivorship of posterior stabilized and
cruciate retaining knee replacement

4. Why was the study needed ?
• Numerous studies comparing CR vs PS TKR
• No conclusive evidence
• Most recent evidence in literature

6. Data Source
• Electronic search – Medline , Embase &
Cochrane register
• Published articles up to Aug 2011
• Reference list of identified articles

7. Index Terms
• ‘total knee replacement’
• ‘total knee arthroplasty’
• ‘posterior cruciate ligament’
• ‘randomized control trials’

8. Study Selection
• RCT comparing CR vs PS – primary TKR
• Revision TKR and high flexion design excluded.
Post op clinical scores
Range of motion
Flexion and extension
Complications

9. Data Extraction
• Sample size
• Study design
• Patient age
• Gender
• Body mass index
• Brand of prosthesis
• Follow up duration
• Knee society score
• Range of motion
• Flexion & Extension angle
• Complications

10. Data Quality
• Methodological quality of included studies –
PEDro - scale

11. Data Analysis
• Metaanalysis performed using “ Review
Manager Software”
• Weighted mean difference
• Odds ratio ( 95% confidence interval)
• Chi square test

13. Results
• 8 studies
• 888 patients – 963 joints
• Follow up – 2 yrs - 7.3 yrs

14. Results
• Post op ROM ( 2 studies )
11deg more in PS gp
• Post op Flexion angle ( 5 studies)
2.88 deg more in PS gp
• Extension – no difference

15. Results
• No significant difference between PS & CR gps
Knee society pain scores
Knee society function scores

16. Results
• No significant difference between PS & CR gps
Rate of complications
Anterior knee pain
Infection
DVT
Revision arthroplasty

17. Study Outcome
• Clinical measures do not significantly differ
• Difference in range of movement – 2 studies

18. Strength of study
• Search methods used to find evidence stated
• Search methods were reasonably
comprehensive
• Reported criteria for including studies
• Included RCTS were validated with
appropriate methods

19. Strength of study
• Method used to analyze data – reported
• Authors have answered the primary question
• Conclusion made by authors supported in
literature
• Conflict of interest stated

20. Limitation of study
• Level 2 evidence
• Funding not reported
• Rotating platform knees included
• Limited to English language articles
• Range of motion available only for 2 studies

24. THANK YOU