REVIEW ARTICLE


https://doi.org/10.5005/jp-journals-10024-2766
The Journal of Contemporary Dental Practice
Volume 21 | Issue 3 | Year 2020

Quality Assessment of Systematic Reviews of Temporomandibular Joint Ankylosis Surgical Treatment Outcomes


Vivekanand S Kattimani1, Abhishek Jairaj2, Nikhil O Govindan3, Paul Mathai4, Swati Sahu5, Abhishek Patley6, Parveen S Sultana7

1Department of Oral and Maxillofacial Surgery, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
2Faculty of Dentistry, AIMST University, Jalan Bedong-Semeling Bedong Kedah, Malaysia
3Department of Oral and Maxillofacial Surgery, Sree Anjaneya Institute of Dental Sciences, Modakkalloor, Calicut, Kerala, India
4Department of Oral and Maxillofacial Surgery and Dentistry, Jubilee Mission Medical College Hospital and Research Institute, Thrissur, Kerala, India
5,6Department of Oral and Maxillofacial Surgery, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India
7Department of Public Health Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India

Corresponding Author: Vivekanand S Kattimani, Department of Oral and Maxillofacial Surgery, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India, Phone: +91 9912400988, e-mail: drvivekanandsk@gmail.com

How to cite this article Kattimani VS, Jairaj A, Govindan NO, et al. Quality Assessment of Systematic Reviews of Temporomandibular Joint Ankylosis Surgical Treatment Outcomes. J Contemp Dent Pract 2020;21(3):337–349.

Source of support: Nil

Conflict of interest: None

ABSTRACT

Aim: Temporomandibular joint ankylosis (TMJA) management involves many surgical treatment modalities depending on the experience of the operator. A lot of literature has been published on various treatment modalities. Many systematic reviews (SRs) were published without any published prior protocol. So, the study aimed to evaluate the quality of SRs with meta-analysis of TMJA management.

Materials and methods: Systematic reviews with meta-analysis were included for the quality assessment using AMSTAR (assessment of multiple SRs) and Glenny et al. checklist by two independent teams. The search was limited to the Medline database archival (from January 1980 to December 2018).

Results: The primary search identified 1,507 related articles. After activation of different filters, abstracts screening, and cross-referencing, finally, a total of six studies were assessed to make the overview up-to-date.

Conclusion: The articles scored 8 to 11 with AMSTAR and 7 to 13 with the Glenny et al. checklist. None of the published reviews received maximum scores. The methodology and heterogeneity are essential factors to assess the quality of the published literature.

Clinical significance: None of the included meta-analysis was registered or published protocol with Prospero or Cochrane before publication for better validity of the studies. The authors are advised to follow reporting criteria so that in the future it is possible to provide the standards of care for TMJA with the highest quality of evidence.

Keywords: Condyle, Cranium, Diarthrodial joint, Evidenced-based dentistry, Systematic review.

INTRODUCTION

Clinical decision making for the treatment approach in dentistry or medicine depends on evidence, published in peer-reviewed journals.13 The decision for the standard of care for any treatment and recommendation depends on remarks of systematic reviews (SRs), randomized-controlled trials (RCTs), cohort studies, and least with retrospective studies.4 For few entities like temporomandibular joint ankylosis (TMJA), it is difficult to find RCTs because of less number of patients with similar clinical presentation, availability of many surgical modalities, and varied clinical scenario of ankylosis. So, it is difficult to ascertain and recommend a single modality of treatment or standardization of methodology. Because of these prevailing factors, the clinician will be in a dilemma during the selection of treatment modality.5 In recent years different protocols were developed, modified for the management of ankylosis.6,7 Thousands of articles were published regarding the management of TMJA. But this evidence is questionable because of varying methodologies and difficulty in reproducibility as ankylosis management and prognosis are multifactorial. So, biomedical journals started following standard publishing guidelines to maintain uniformity while reporting.8

In recent past, publishers adopted various reporting guidelines like CONSORT (Consolidated Standards of Reporting Trials), STROBE (STrengthening the Reporting of OBservational studies in Epidemiology), SPIRIT (standard protocol items for clinical trials), SQQR (standards for reporting qualitative research), etc., for various types of article publications.8 These guidelines help clinicians to prevent publication bias. Multiple tools were also developed to critically analyze the methodological quality of SRs and provide the recommendations based on the highest evidence.912

The available SRs showed that only 40.5% of the studies assessed the risk of bias/quality.3 Till date, quality assessment of the published reviews on TMJA had not been performed.2,13 In the wake of this diversity, the overview of SR articles with meta-analysis (MA) regarding comparative surgical treatment outcomes of TMJA was planned to assess and compare the quality using two types of tools: AMSTAR9 (assessment of multiple SRs) and the Glenny10 checklist.

MATERIALS AND METHODS

An electronic search was performed with the date and no language restriction. The search included articles published from January 1980 to December 2018 using various Boolean operators with multiple combinations of search strings in the Medline database. Depending on the title, abstract and full-text articles published in the English language were selected for reading with the following selection criteria to ascertain the objective. Only published articles of TMJA surgical treatment outcomes SR with MA were included for assessment. After initial screening, full-text articles were selected for critical reading and analysis. The authors were contacted for further clarification if the ambiguity in the published data exists. Two independent teams assessed the quality of included studies using AMSTAR9 and the Glenny et al.10 checklist.

The scoring was performed according to the characteristics of the study for a quality check as per the checklist. These criteria were based on the questions framed by AMSTAR9 and Glenny et al.10 for the assessment of quality check of published SR and MA. These questions assess how well the SR and MA were performed to reach the consensus on the treatment outcomes depending on the objectives of the study. The AMSTAR9 checklist consists of 11 questions, whereas the Glenny et al.10 list consists of 14 questions to assess quality. These questions/evaluative factors assess search criteria, methodology, the prior publication of the protocol, the validity of statistics of included studies, consideration of bias factors, any missing data, method of data collection, scientific quality, heterogeneity, and conclusive remarks based on the rationale supported by outcomes of the included primary studies. Differences in scoring among the two teams sorted with discussion. The methodological quality and statistics was assessed by a team of review members involving a public health dentist. The following search criteria with MeSH words were applied to generate the required data from the Medline archival.

Search Criteria and Data Screening

A literature search was performed using four search categories, which included various Boolean operators and MeSH keywords related to treatment outcomes of surgical management of TMJ ankylosis (Table S1 supplementary material).

Statistical Analysis

The data were collected using both quality assessment tools and were analyzed using descriptive statistics. The Spearman correlation test was performed for determining correlation between the two scoring criteria.

RESULTS

After going through the abstract of all final results of four search categories (Table S1) and narrowing down the search to address the objective of quality assessment, authors found 10 publications (Flowchart 1). After going through full-length articles, out of ten, one was in the French language, another was American Association of Oral and Maxillofacial Surgeons (AAOMS) guidelines not focused on comparisons, and three were descriptive reviews focused mainly on the effects of various surgical treatment modalities in ankylosis without MA (Table 1).1418 Five studies were found eligible for the review, but our team found one more recently published study,5 which has been added for final assessment to make an effort more complete and up-to-date and which rose the total number of included studies to six.

Flowchart 1: Screening and selection process

Table 1: List of excluded studies and the reason for their exclusion
Author and yearReason for exclusion
Sporniak-Tutak et al.14 (2011)Descriptive review
Movahed and Mercuri15 (2015)Descriptive review
Sharma et al.16 (2017)Descriptive review
Bénateau et al.17 (2016)Other than the English language (in French)
AAOMS ParCare18 (2012)Not focused exclusively on comparative TMJ surgeries

Study Characteristics

The scoring for included studies is presented in Table 2 (other characteristics continued in Tables S2 and S3 as supplementary material). Katsnelson19 included four studies2023 searched between 1966 and May 2010. Al-Moraissi et al.24 included 16 publications2023,2536 (nine retrospective studies and seven controlled clinical trials) searched in December 2013 without date restrictions. Ma et al.37 included eight retrospective cohort studies and were searched up to October 11, 2014. Ma et al.38 published one more study that included eight studies23,26,28,30,31,36,39,40 searched between 1946 and July 28, 2014. De Roo et al.41 publication included 38 studies2123,28,31,4273 with four prospective and one RCT, and other study types were not mentioned. Mittal et al.5 included 26 studies2023,2628,3032,34,39,40,48,53,66,72,7482 for MA.

Table 2: Main characteristics and quality assessment scores obtained using AMSTAR and Glenny et al. checklist
AuthorsReference numberNo. of studies includedOutcome measuresAMSTAR score (lowest 0, highest 11)Checklist of Glenny et al. (lowest 0, highest 14)
Katsnelson194Maximal inter-incisal opening87
Al-Moraissi2416Maximal inter-incisal opening1110
Ma et al.378Maximal inter-incisal opening and incidence of reankylosis1112
Ma et al.388Maximal inter-incisal opening and incidence of reankylosis1113
De Roo et al.4138Maximal inter-incisal opening1111
Mittal et al.526Incidence of reankylosis and maximal inter-incisal opening1111
Table 3: AMSTAR checklist and the number of studies that satisfied each of the criteria
S. no.AMSTAR questionsKatsnelson19Al-Moraissi et al.24Ma et al.37Ma et al.38De Roo et al.41Mittal et al.5
1Was an a priori design provided?YesYesYesYesYesYes
2Is there a duplicate study selection and data extraction?YesYesYesYesYesYes
3Was a comprehensive literature search performed?YesYesYesYesYesYes
4Was the status of the publication (i.e., grey literature) used as an inclusion criterion?Yes, no mention of grey literatureYes, no mention of grey literatureYes, no mention of grey literatureYes, no mention of grey literatureYes, no mention of grey literatureYes, no mention of grey literature
5Was a list of studies (included and excluded) provided?NoYesYesYes, but no list of excluded studiesYes, but no record of excluded studiesYes
6Were the characteristics of the included studies provided?YesYesYesYesYesYes
7Was the scientific quality of the included studies assessed and documented?NoYesYesYesYesYes
8Was the scientific quality of the included studies used appropriately in formulating conclusions?YesYesYesYesYes, using a customized frameworkYes
9Were the methods used to combine the findings of studies appropriate?YesYesYesYesYesYes
10Was the likelihood of publication bias assessed?YesYesYesYesYesYes
11Was the conflict of interest stated?NoYesYesYesYesYes

Quality Assessment

None of the published reviews included in this overview met all the AMSTAR criteria (Table 3). The scores ranged from 8 points to 11 points. Point 4 of the AMSTAR guideline was partly explained in all publications. One study19 received the lowest score indicating poorly performed study involving four articles for review and MA, whereas the other publications5,24,37,38,41 received a score of 11. Two of the MA were published in the same year by the same author with different objectives involving eight studies each for MA.37,38

The scores for the Glenny et al.10 checklist varied between 7 points and 13 points (Table 4). Spearman’s correlation was positive between the scores of two quality assessment tools, with a coefficient of 0.66 (p = 0.15) (Fig. 1). The mean and SD score for AMSTAR was 10.50 ± 1.22 and for Glenny et al. was 10.67 ± 2.06 (Table S4 supplementary material).

Table 4: Checklist of Glenny et al. and the number of studies that satisfied each of the criteria
S. no.Glenny et al. questionsKatsnelson19Al-Moraissi et al.24Ma et al.37Ma et al.38De Roo et al.41Mittal et al.5
1Did the reviewer address a focused question?YesYesYesYesYesYes
2Did the authors look for appropriate papers?YesYesYesYesYesYes
3Did the authors attempt to identify all relevant studies?YesYesYesYesYesYes
4Did the authors search for published and unpublished literature?Unpublished not mentionedUnpublished not mentionedUnpublished not mentionedUnpublished not mentionedUnpublished not mentionedUnpublished not mentioned
5Were all languages considered?Not mentionedYesNot mentionedYesYesNot mentioned
6Was any hand-searching carried out?YesYesYesYesYesYes
7Was it stated that at least two reviewers applied the inclusion criteria?No, one author performedNot mentionedYesYesYesYes
8Did reviewers attempt to assess the quality of the included studies?Partly assessed using publication biasAssessedYesYesYesYes
9If so, did they include this quality assessment in the analysis?No, only publication bias assessedYesYesYesNoYes
10Was it stated that the quality assessment was carried out by at least two reviewers?NoNoYesYesNoNot mentioned
11If the results have been combined, was it reasonable to do so?YesYesYesYesYesYes
12Are the results clearly displayed?YesYesYesYesYesYes
13Was an assessment of heterogeneity made, and were reasons for variation discussed?NoYesYesYesYesYes
14Were the results of the review interpreted appropriately?YesYesYesYesYesYes

DISCUSSION

This overview is limited to SRs with a MA that evaluated the various surgical techniques used in the management of TMJA and its outcomes in humans. The TMJA prognosis is multifactorial; to date, no consensus on the standards of care has been advised. It might be attributed to patient and clinician factors broadly. Many attempts have been made in the past to assess the published literature.5,19,24,37,38,41 Few SRs are published with and without MA.5,14,15,19,24,37,38,41 Surprisingly, it was noted that variations in the number of included studies despite almost the same outcomes are being evaluated and published in the same year and same journal.37,41 This variation might be attributed to the inclusion and exclusion criteria. Despite the increased number of publications, the quality of the publications has not reached the highest scoring.

The recent study5 is published after a gap of 4 years from the last published literature,41 but it includes a lesser number of studies compared to the previous research for interpretation even though the scope has been broadened by adding the distraction osteogenesis.5 The lack of inclusiveness of the previous MA (Ma et al., 201537,38) in discussion indicates methodological flaws in the search criteria.41 So, a more rigorous researching and reviewing approach is necessary for better evidence and conclusive remarks. The authors have not found the Prospero/Cochrane protocol for the published studies included in this overview. The SRs with or without MA should register its protocol in Prospero or Cochrane systemic protocol reviews for validity, which in turn prevents duplication of studies and methodological flaws. Leaving apart the Kabans protocol, the existing literature is unable to draw any further conclusive remarks.6,7 So, the readers should exercise caution while adopting the interpretation and conclusive remarks.

Fig. 1: Correlation between AMSTAR and Glenny et al. scores

The increase in scoring indicates an improvement in the reporting pattern from the first MA19 (the year 2012) to the latest published5 (the year 2019). The number of published articles were increased because of the shift of the thought process from gap arthroplasty to interposition arthroplasty and reconstruction arthroplasty using various techniques that have widened the scope of the study.5,19,24,37,38,41 This paradigm shift in surgical management made the prognosis better with reduced postoperative complications and improved patient compliance, function, and aesthetics. The reporting quality of RCT, controlled clinical trail (CCT), or case series needs to be improved for better evidence.83 None of the published studies reported TMJA classification before intervention, so it might have given a better edge for correlation of the surgical method and prognosis. Although the publications reviewed had similar objectives in this overview, but they had high methodological heterogeneity. However, these SRs did not meet all of the criteria of the checklists used, indicating potential publication bias.

The risk of bias assessment is essential for individual studies.83 Adopting the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach for the synthesis of evidence would be a significant step for improving the quality of clinical evidence.83 The International Committee of Medical Journal Editors (ICMJE)84 set many reporting guidelines for human clinical series or CCT or RCT publications. If authors adhere strictly to these reporting criteria, then better evidence can be provided, which can be universally adopted for developing the TMJA treatment protocol. High-quality reviews may help the clinicians and patients to have the best possible results.83 The publication bias assessment and homogeneity are fundamental for the studies considered in MA.2,3 These factors clarify the reader the methodological quality opted for the same. Quality assessments, such as the Cochrane Collaboration’s tool for assessing the risk of bias for RCTs and Newcastle–Ottawa Quality Assessment Scale for cohort studies, were used in the included studies.

The TMJA surgical management outcome analysis consists of several confounding factors. Some of them should be included in inclusion or exclusion criteria so that the effect can be minimized. The time duration of ankylosis, type, age, treatment provided, postsurgical monitoring, etc., are important factors along with the surgical expertise of the clinicians for the better outcome. Even though the study included extensive quality checks using checklists but these lists lack of quantitative assessment. In our study, the lowest score obtained was 7. Despite the lack of standard reference scale for discrimination as poor or good study, the score below 3 was considered as poorly designed.4,85 But in our overview, we found moderate scored reviews.

The checklists used in this overview are more comprehensive and were used extensively with validation for the quality checks. Many other tools are available but are not so comprehensive and not provide scoring.9,11,12,8688 Because of the scoring, it is possible to correlate using Spearman’s correlation, which measures the relationship between two variables. So, we have used these two checklists. In this study, the scores were positively correlated, indicating a lower possibility of errors and a lower risk of bias in the scoring system implemented.

The study has limited the critical assessment to the English language literature archived in the Medline database for the accuracy, reproducibility, and quality of publications for evaluation. The increase in predatory journal publications is worrying some for the evidence published, and the involvement of such studies as reference might mislead the outcome or recommendation.13,84

CONCLUSION

The clinicians and researchers, as a result of this, advised to look after the reporting guidelines and adhere to the protocol of reviews for better evidence. Authors cautioned to refer the valid, researchable, and indexed journals for better validity as few of the MA referenced predatory journals in their research, which may undermine the objective of SR and MA. The word of caution is always better for better evidence creation for the future generation and the standard of care.

AUTHOR CONTRIBUTIONS

Vivekanand S Kattimani and Abhishek Jairaj drafted the protocol; Vivekanand S Kattiman, Abhishek Jairaj, and Shaik Parveen Sultana developed a search strategy. Team 1, Vivekanand S Kattimani, Abhishek Jairaj, Shaik Parveen Sultana, and Team 2, Nikhil O Govindan, Paul Mathai, Swati Sahu, Abhishek Patley, searched for literature. Vivekanand S Kattimani, Abhishek Jairaj, and Swati Sahu selected articles to include in this analysis. Paul Mathai and Abhishek Patley obtained copies of publications of all included studies. Vivekanand S Kattimani, Nikhil O Govindan and Swati Sahu extracted data from publications. Abhishek Jairaj and Shaik Parveen Sultana verified the data entered for analysis. Shaik Parveen Sultana carried out the analysis part. Vivekanand S Kattimani, Abhishek Jairaj, and Shaik Parveen Sultana interpreted the analysis; Vivekanand S Kattimani and Abhishek Jairaj drafted the final review. All the authors read and approved the final version.

ETHICAL APPROVAL

Not required, as it does not involve humans or animals in the study.

ACKNOWLEDGMENTS

All authors have viewed and agreed to the submission.

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Table S1: Search methods performed in PubMed to retrieve the suitable data for assessment with search results obtained for evaluation
SearchThe methodology of search and use of various Boolean operators and MeSH termsDescription of search criteria and results obtained
First search(“ankylosis”[MeSH Terms] OR “ankylosis”[All Fields]) AND ((“surgical procedures, operative”[MeSH Terms] OR (“surgical”[All Fields] AND “procedures”[All Fields] AND “operative”[All Fields]) OR “operative surgical procedures”[All Fields] OR “surgical”[All Fields]) AND (“organization and administration”[MeSH Terms] OR (“organization”[All Fields] AND “administration”[All Fields]) OR “organization and administration”[All Fields] OR “management”[All Fields] OR “disease management”[MeSH Terms] OR (“disease”[All Fields] AND “management”[All Fields]) OR “disease management”[All Fields])) AND (Review[ptyp] AND (“1980/01/01”[PDAT]: “2018/12/31”[PDAT]) AND “humans”[MeSH Terms])The results obtained with the following filters activated: Review, Publication date from 1980/01/01 to 2018/12/31, Humans; the search team found total of 5 publications out of 615 items
Second search(“Temporomandibular ankylosis”[Supplementary Concept] OR “Temporomandibular ankylosis”[All Fields] OR “temporomandibular ankylosis”[All Fields]) AND ((“surgical procedures, operative”[MeSH Terms] OR (“surgical”[All Fields] AND “procedures”[All Fields] AND “operative”[All Fields]) OR “operative surgical procedures”[All Fields] OR “surgical”[All Fields]) AND (“organization and administration”[MeSH Terms] OR (“organization”[All Fields] AND “administration”[All Fields]) OR “organization and administration”[All Fields] OR “management”[All Fields] OR “disease management”[MeSH Terms] OR (“disease”[All Fields] AND “management”[All Fields]) OR “disease management”[All Fields])) AND (Review[ptyp] AND (“1980/01/01”[PDAT]: “2018/12/31”[PDAT]) AND “humans”[MeSH Terms])The results obtained with following filters activated: Review, Publication date from 1980/01/01 to 2018/12/31, Humans; the search team found 5 publications out of 46 items
Third search((“Temporomandibular ankylosis”[Supplementary Concept] OR “Temporomandibular ankylosis”[All Fields] OR “temporomandibular ankylosis”[All Fields]) AND (“organization and administration”[MeSH Terms] OR (“organization”[All Fields] AND “administration”[All Fields]) OR “organization and administration”[All Fields] OR “management”[All Fields] OR “disease management”[MeSH Terms] OR (“disease”[All Fields] AND “management”[All Fields]) OR “disease management”[All Fields])) AND (Review[ptyp] AND (“1980/01/01”[PDAT]: “2018/12/31”[PDAT]) AND “humans”[MeSH Terms])The results obtained with the following filters activated: Publication date from 1980/01/01 to 2018/12/31, Humans; the search team found 164 out of 231 items. Further activation of Filter: Review, resulted in 11 publications
Fourth search(“Temporomandibular ankylosis”[Supplementary Concept] OR “Temporomandibular ankylosis”[All Fields] OR “temporomandibular ankylosis”[All Fields]) AND ((“1980/01/01”[PDAT]: “2018/12/31”[PDAT]) AND “humans”[MeSH Terms])The results obtained with the following filters activated: Review, Publication date from 1980/01/01 to 2018/12/31, Humans; the search team found 85 publications out of 615 items
Table S2: Study characteristics of involved reviews (continued) (supplemental material)
Study characteristicsKatsnelson19Al-Moraissi et al.24Ma et al.37Ma et al.38De Roo et al.41Mittal et al.5
Electronic databases search sites includedPubMed, Cochrane Central Register of Controlled Trials online abstract indexes of the conference proceedings of the American Association of Oral and Maxillofacial Surgeons and the International Association for Dental Research annual meetingsPubMed, Cochrane database of systematic reviews, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, MEDLINE, CINAH, SPORTDiscus, and Electronic Journals CenterPubMed, EMBASE, OVID EBM reviews, and Web of SciencePubMed, EMBASE, Cochrane Library, Web of Science and China National knowledge, infrastructurePubMed and the Web of Science and Cochrane LibraryPubMed, Ovid, Embase, Web of Science, Scopus, and Cochrane central register of controlled trials (CENTRAL)
Protocol opted for data extractionStandardized data extraction formCustomized data extraction formCustomized data extraction formCustomized data extraction formCustomized data extraction form with following Altman, STROBE (strengthening the reporting of observational studies in epidemiology) and Cochrane Library frameworkCustomized data extraction form
Method opted for scientific quality assessmentNot assessedAs per the checklist proposed by Rangel et al. and Versteegh et al.Newcastle-Ottawa scale (NOS)Newcastle-Ottawa scale (NOS)STROBE guidelines but no scoring mentionedNewcastle Ottawa Scale
Method opted for publication bias assessmentBegg’s funnel plots and Egger’s testBegg’s funnel plotBegg’s funnel plots and Egger’s testBegg’s funnel plots and Egger’s testEgger’s testEgger’s test
Review design method optedQUOROM (quality of reporting of meta-analyses) guidelinesPreferred reporting items for systematic reviews and meta-analyses (PRISMA)-E 2012 checklistNot mentionedMOOSE guidelinesPRISMA guidelinesNot mentioned
Heterogeneity assessmentNot mentionedCochran’s test and the I2 statistic2 and I2 statisticChi-square and I-squared testsI-squared testChi-square and I-squared tests
Statistical analysisSTATA version 9.2RevMan 5.2.6 softwareRevMan 5.3 software and STATA version.12RevMan 5.3 software and STATA version.12STATA version.12RevMan 5.3
Information of prior protocol publicationNoNoNoNoNoNo
Table S3: Study details extracted from the MA selected for critical analysis (supplemental material)
S. no.Author and yearNo. of patients includedData search timelineInvestigator and year of publicationType of study
1Katsnelson19 (2012)52 patients in one group and 39 patients in another groupJanuary 1966 through May 2010Manganello, 2003Not mentioned
Balaji, 2003Not mentioned
Qudah et al., 2005Not mentioned
Tanrikulu et al., 2005Not mentioned
2Al-Moraissi et al.24 (2014)Saeed et al. 2002Retrospective study
Balaji, 2003Control clinical trial
Manganello, 2003Control clinical trial
Tanrikulu et al., 2005Retrospective study
Qudah et al., 2005Retrospective study
Ramezanian and Yavary et al., 2006Control clinical trial
Vasconcelos et al., 2009Retrospective study
Danda et al., 2009Control clinical trial
Tang et al., 2009Retrospective study
Zhi et al., 2009Retrospective study
Elgazzar et al. 2010Retrospective study
Loveless et al., 2010Retrospective study
Mansoor et al., 2013Control clinical trial
Shaikh et al., 2013Control clinical trial
Mabongo, 2013Retrospective study
Holmlund et al., 2013Controlled clinical trail
3Ma et al.37 (2015)Reconstruction arthroplasty group 106 and Interposition arthroplasty 92 patients among 6 studiesNo time restriction search performed up to October 11, 2014Balaji, 2003Retrospective cohort study
Manganello, 2003Retrospective cohort study
Tanrikulu, 2005Retrospective cohort study
Qudah, 2005Retrospective cohort study
Erol, 2006Retrospective cohort study
Loveless, 2010Retrospective cohort study
Elgazzar, 2010Retrospective cohort study
Sahoo, 2012Retrospective cohort study
4Ma et al.38 (2015)Total of 272 patients among eight studies divided into two groupsFrom 1946 to July 28, 2014Hu, 2005Retrospective cohort study
Tanrikulu, 2005Retrospective cohort study
Erol, 2006Retrospective cohort study
Ramezanian, 2006Retrospective cohort study
Danda, 2009Retrospective cohort study
Zhi, 2009Retrospective cohort study
Elgazzar, 2010Retrospective cohort study
Holmlund, 2013Retrospective cohort study
5De Roo et al.41 (2015)Total of 1,165 patients among 36 studies further divided into five groups consisting of GA-463, IA auto-341, IA allo-68, RA auto-260, and RA allo-33Up to October 11, 2014Rajgopal, et al., 1983Not mentioned
Chossegros et al., 1997Not mentioned
Karaca et al., 1998Not mentioned
Chossegros et al., 1999Not mentioned
Roychoudhury et al., 1999Not mentioned
Erdem and Alkan, 2001Not mentioned
Valentini et al., 2002Not mentioned
Manganello, 2003Not mentioned
Guven, 2004Not mentioned
Dimitroulis, 2004Not mentioned
Qudah et al., 2005Not mentioned
Tanrikulu et al., 2005Not mentioned
Li et al., 2006Not mentioned
Huang et al., 2007Not mentioned
Guven, 2008Not mentioned
El-Sayed, 2008Not mentioned
Krishnan, 2008Not mentioned
Mehrotra et al., 2008Not mentioned
Bayat et al., 2009Not mentioned
Danda et al., 2009Not mentioned
Yazdani et al., 2010Prospective study
Liu et al., 2010Not mentioned
Elgazzar et al., 2010Not mentioned
Liu et al., 2011Not mentioned
Singh et al., 2011aNot mentioned
Singh et al., 2011bNot mentioned
Yang et al., 2011Not mentioned
Gaba et al., 2012Prospective study
Mehrotra et al., 2012Randomized controlled trial
Nitzan et al., 2012Not mentioned
Sahoo et al., 2012Not mentioned
Singh et al., 2012Prospective study
Babu et al., 2013Prospective study
Jakhar et al., 2013Not mentioned
Karamese et al., 2013Not mentioned
Zhu et al., 2013Not mentioned
Bhatt et al., 2014Not mentioned
Singh et al., 2014Not mentioned
6Mittal et al.5 (2019)Total of 1,197 patients among 26 studies. Further divided into groupsSearched till April 2018Valentini et al., 2002Nonrandomized controlled trial
Balaji, 2003Retrospective study
Souza and Mariani, 2003Nonrandomized controlled trial
Hu et al., 2005Retrospective study
Tanrikulu et al., 2005Retrospective study
Qudah et al., 2005Retrospective study
Ramezanian and Yavary, 2006Nonrandomized controlled trial
Erol et al., 2007Retrospective study
Güven et al., 2008Retrospective study
Danda et al., 2009Nonrandomized controlled trial
Kummoona et al., 2009Nonrandomized controlled trial
Vasconcelos et al., 2009Retrospective study
Zhi et al., 2009Retrospective study
Elgazzar et al., 2010Retrospective study
Loveless et al., 2010Retrospective study
Sahoo et al., 2012Retrospective study
Shaikh et al., 2013Nonrandomized controlled trial
Bhatt et al., 2014Retrospective study
Kumar et al., 2014Retrospective study
Ahmad et al., 2015Nonrandomized controlled trial
Bhardwaj and Arya, 2016Retrospective study
Denadai et al., 2016Retrospective study
Shakeel et al., 2016Retrospective study
Dad and Uppal, 2017Retrospective study
Jiang et al., 2017Retrospective study
Xu et al., 2017Retrospective study
Table S4: Spearman’s rank correlation between AMSTAR and Glenny et al. scores
 nSpearman Rt(N-2)p-level
AMSTA and Glenny et al. scores60.66421.77700.1502

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