Comparison of the coverage and rotation of asymmetrical and symmetrical tibial components: a systematic review and meta-analysis

• Published in: BMC musculoskeletal disorders Vol. 25; no. 1; p. 336
• Main Authors: Zhang, Ziming, Zhang, Tiantian, Zhang, Le, Chen, Zehua, Zhao, Haoming, Kuang, Jianjun, Ou, Liang
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 26.04.2024; BioMed Central; BMC
• Subjects: Arthroplasty (knee); Arthroplasty, Replacement, Knee - instrumentation; Arthroplasty, Replacement, Knee - methods; Asymmetric tibial component; Bias; Clinical outcomes; Cohort analysis; Collaboration; Humans; Implants, Artificial; Joint replacement surgery; Knee; Knee Joint - surgery; Knee Prosthesis; Meta-analysis; Methods; Osteoarthritis, Knee - surgery; Prostheses; Prosthesis; Prosthesis Design; Quality control; Range of Motion, Articular; Reviews; Rotation; Rotational alignment; Systematic review; Tibia - surgery; Tibial baseplate; Total knee arthroplasty; Treatment Outcome; China; Rotational alignment; Total knee arthroplasty; Tibial baseplate; Asymmetric tibial component
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-024-07466-2

An optimized fit of the tibial component to the resection platform and correct rotational alignment are critical for successful total knee arthroplasty (TKA). However, there remains controversy regarding the superiority of symmetric tibial component versus asymmetric tibial component. The objective of this systematic review and meta-analysis was to evaluate the current evidence for comparing the coverage and rotation of asymmetrical and symmetrical tibial component. We searched potentially relevant studies form PubMed, Web of science, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and China National Knowledge Infrastructure (CNKI), up to 1 March 2023. Data extraction and quality assessment were performed by two independent reviewers. Meta-analysis was conducted using Review Manager 5.4. Sixteen articles were identified. Compared to symmetric tibial component, asymmetric tibial component increased the coverage of the proximal tibial cut surface (MD, -2.87; 95%CI, -3.45 to -2.28; P < 0.00001), improved the prevalence of tibial baseplate underhang (OR, 0.16; 95%CI, 0.07 to 0.33; P < 0.00001) and malrotation (OR, 0.13; 95%CI, 0.02 to 0.90; P = 0.04), and reduced the degree of tibial component rotation (MD, -3.11; 95%CI, -5.76 to -0.47; P = 0.02). But there was no statistical significance for improving tibial baseplate overhang (OR, 0.58; 95%CI, 0.08 to 3.97; P = 0.58). Additionally, no revision had occurred for the two tibial components in the included studies. The current evidence shows asymmetric tibial component offer advantages in terms of coverage and rotation compared with symmetric tibial component in TKA.