PATIENT OUTCOMES FOLLOWING TRICOMPARTMENTAL TOTAL KNEE REPLACEMENT - A METAANALYSIS

Objective.-To provide estimates of patient outcomes following tricompa rtmental knee replacement and to examine variation in outcomes due to patient and prosthesis characteristics. Data Sources.-English-language articles identified through a computerized literature search and bibl iography review. Study Selection.-Studies were included it they enroll ed 10 or more patients at the time of initial knee replacement and mea sured patient outcomes using a global knee-rating scale. Data Extracti on.-Each study was subjected to a blinded qualitative assessment and u nblinded abstraction of patient characteristics, surgical techniques, and outcomes. Data Synthesis.-A total of 130 studies reporting patient outcomes on 154 cohorts satisfied inclusion criteria. The total numbe r of enrolled patients was 9879 with a mean enrollment of 64.1 patient s. The mean follow-up was 4.1 years. The mean patient age was 65.0 yea rs, 71.7% of patients were women, 62.6% had osteoarthritis, and 26.6% underwent bilateral knee replacement. Global rating scale scores impro ved by 100% for the typical enrolled patient, and 89.3% of patients re ported good or excellent outcomes. Anatomic classification of the pros thesis, percentage of enrolled patients with osteoarthritis, publicati on year, and number of enrolled patients explained 27% of the variatio n in reported mean postoperative global rating scale scores. The weigh ted mean complication rate was 18.1%, and the mean mortality rate per year of follow-up was 1.5%. The overall rate of revision during 4.1 ye ars was 3.8%. Conclusions.-Tricompartmental knee replacement was a saf e and effective procedure for the patients reported in these studies. The knee pathology and the type of prosthesis were significant predict ors of outcomes. Limitations in the reporting style of these articles severely constrain the ability to explore variation in outcomes due to study, patient, or prosthesis characteristics and restrict their gene ralizability.