No Superiority of High-Flexion vs Standard Total Knee Arthroplasty: An Update Meta-Analysis of Randomized Controlled Trials

This meta-analysis was performed using a Cochrane systematic review approach to examine published data with an aim to clarify whether standard or high flexion prostheses increase the range of knee motion and clinical outcomes. 1778 patients from 17 randomized controlled trials were identified. No significant differences in the range of motion, weight-bearing flexion and hip functions scores were found between treatment groups. We also found no significant differences in complications with regard to revision, component loosening, deep infection, anterior knee pain, stiffness, post-operative bone fracture and post-operative patella clunk syndrome, but the high flexion prostheses group had a higher incidence of deep venous thrombosis. The results do not support the proposition that high flexion knee prostheses provide substantial clinical advantages over standard knee prostheses.