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Background: Numerous systematic reviews have been published comparing the outcomes of patients undergoing posterior stabilized (PS) versus cruciate-retaining (CR) procedures in total knee arthroplasty (TKA), but with some overlaps and contradictions. The objectives of this study were (1) to perform an overview of current systematic reviews comparing PS versus CR in TKA, by evaluating their methodological quality and risk of bias, and (2) to provide recommendations through the best evidence. Methods: A systematic search of systematic reviews comparing PS and CR in TKA, published until June 2021 was conducted using the MEDLINE, EMBASE, and Cochrane Library databases. Included systematic reviews were assessed for methodological quality and risk of bias by the AMSTAR2 instrument and ROBIS tool, respectively. The choice of best evidence was conducted according to the Jadad decision algorithm. Results: A total of eight systematic reviews were eligible for inclusion in this study. The Jadad decision algorithm suggested that reviews with the highest AMSTAR2 scores should be selected. According to the ROBIS tool, there were three reviews with a low risk of bias and five with a high risk of bias. Consequently, one systematic review conducted by Verra et al. with the highest AMSTAR2 score and low risk of bias was selected as the best evidence. Conclusions: Although current systematic reviews demonstrated some statistical differences in clinical presentation and functional outcomes between PS and CR, the current outcome indicators cannot be taken to provide recommendations for undergoing PS or CR. The decision for prosthesis selection could be made mostly based on the surgeon's preference, indications and other indicators. [ABSTRACT FROM AUTHOR]

Numerous systematic reviews investigating the effects of mesenchymal stem cells (MSCs) in treating knee osteoarthritis (OA) have been published with controversial conclusion. The purpose of the overview was (1) to perform an overview of systematic reviews investigating MSCs for knee OA and (2) to synthesize evidence qualitatively to assess confidence in the review findings. A systematic search of systematic reviews published through Aug 2017 was conducted using the MEDLINE, EMBASE and Cochrane Library. The methodological quality and risk of bias of included systematic reviews was assessed by AMSTAR instrument and ROBIS tool, respectively. Best evidence choice procedure was conducted according to the Jadad decision algorithm. The systematic reviews with high methodological quality and low risk of bias were selected ultimately for further evidence synthesis based on the CERQual tool. Four systematic reviews were eligible for inclusion. According to the ROBIS tool, there was one systematic review with low risk of bias and three with high risk of bias. Thus, only one systematic review conducted by Pas et al. with highest AMSTAR score and low risk of bias was selected. For all outcomes after evidence synthesis via the CERQual tool, confidence for decision making was either low (self-reported measurement and MRI/histological outcome) or moderate (adverse events). The present study demonstrates that moderate confidence could be placed in safety of MSCs therapy for knee OA, but with low confidence in efficacy outcomes due to limitations of the current evidence. Further high-quality studies with high internal and external validity are still required. [ABSTRACT FROM AUTHOR]