No Clinical Benefit of High-Flex Total Knee Arthroplasty. A Meta-Analysis of Randomized Controlled Trials

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.