title: No difference in clinical outcomes after total knee arthroplasty between patellar eversion and non-eversion.
abstract: OBJECTIVE
  Multiple surgical techniques in minimally invasive total knee arthroplasty (TKA) are associated with clinical differences. However, whether patellar eversion impairs clinical outcomes remains controversial. We conducted a systematic review of randomized controlled trials (RCTs) to provide current understanding on this topic.
  
  
  METHODS
  A literature search of the PubMed, Embase, and Cochrane library databases was performed to identify RCTs comparing patellar eversion with patellar non-eversion (PN). Two authors independently selected the studies, assessed methodological quality, and extracted data.
  
  
  RESULTS
  Five RCTs involving 379 knees were included. The results revealed no significant differences in functional scores, pain, quality of life, quadriceps strength, patellar height, alignment, or complication rate between patellar eversion and PN. Power analysis showed that the power of the individual study and meta-analysis ranged from 5.0 to 70.8%, with the exception of the power of alignment and patellar height in two of the individual studies, which was 100.0 and 99.9%, respectively.
  
  
  CONCLUSIONS
  Based on the current evidence, patellar eversion during TKA could not definitely lead to inferior postoperative outcomes. Patellar eversion and patellar non-eversion could achieve similar clinical outcomes.
  
  
  METHODS
  Systematic review and meta-analysis, Level I.
authors.affiliation: Department of Orthopaedics, Navy General Hospital, No. 6, Fucheng Road, Beijing, 100048, China.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Jia
authors.affiliation: Department of Orthopaedics, Navy General Hospital, No. 6, Fucheng Road, Beijing, 100048, China.|The Third Clinical Medical College, Southern Medical University, Guangzhou, China.
authors.forename: Chun
authors.initials: C
authors.lastname: Chen
authors.affiliation: Department of Orthopaedics, Navy General Hospital, No. 6, Fucheng Road, Beijing, 100048, China.|The Third Clinical Medical College, Southern Medical University, Guangzhou, China.
authors.forename: Yaohong
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Orthopaedics, Wuhan Pu'Ai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Ding
authors.affiliation: Graduate College, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Tian
authors.affiliation: Department of Orthopaedics, Navy General Hospital, No. 6, Fucheng Road, Beijing, 100048, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Orthopaedics, Navy General Hospital, No. 6, Fucheng Road, Beijing, 100048, China.
authors.forename: Deli
authors.initials: D
authors.lastname: Wang
authors.affiliation: Department of Orthopaedics, Navy General Hospital, No. 6, Fucheng Road, Beijing, 100048, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: He
authors.affiliation: Department of Orthopaedics, Navy General Hospital, No. 6, Fucheng Road, Beijing, 100048, China. ruandikengh@163.com.
authors.forename: Dike
authors.initials: D
authors.lastname: Ruan
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D006801:Humans; D053580:Muscle Strength; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis; D010329:Patella / Q000601:surgery*; D052097:Quadriceps Muscle / Q000601:surgery*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function; D016896:Treatment Outcome
keywords: Meta-analysis; Patellar eversion; Systematic review; Total knee arthroplasty