title: No clinical benefit of high-flex total knee arthroplasty. A meta-analysis of randomized controlled trials.
abstract: The application of high-flex prosthesis in total knee arthroplasty (TKA) is an area of continuing debate. Thus, we conducted a meta-analysis of randomized controlled trials (RCTs). A literature search was performed in PubMed, EMBASE and the Cochrane database. 10 trials involving 1230 knee joints were eligible for our meta-analysis. No significant difference was observed between the two designs regarding postoperative range of flexion, clinical scores, quality of life outcomes, or complication rate. Moreover, the advantage of high-flex implants for patients with high preoperative range remained not statistically significant and high-flex design in NexGen system showed a marginal improvement in the postoperative range of flexion. Based on current findings, high-flex prosthesis did not appear to confer any benefit as compared to standard prosthesis.
authors.affiliation: Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Huichao
authors.initials: H
authors.lastname: Fu
authors.affiliation: Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Jiaxing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Wen
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Tao
authors.initials: T
authors.lastname: Cheng
authors.affiliation: Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Xianlong
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016059:Range of Motion, Articular; D016896:Treatment Outcome
keywords: high flex; meta-analysis; posterior stabilized; range of flexion; total knee arthroplasty