胫骨高位截骨与单髁置换治疗单室膝骨性关节炎的荟萃分析

被引：27

作者：

罗旺林 ^{[1
,2
]}

殷德雄 ^{[1
,2
]}

彭超 ^{[2
]}

刘勇 ^{[2
]}

机构：

[1] 西藏大学医学院

[2] 西藏自治区人民医院骨科

来源：

中国矫形外科杂志 | 2018年 / 09期

关键词：

胫骨高位截骨; 单髁置换术; 单间室骨性关节炎; Meta分析;

D O I：

暂无

中图分类号：

R687.4 [关节手术];

学科分类号：

100220 [骨科学];

摘要：

[目的]通过Meta分析系统评价胫骨高位截骨术(high tibial osteotomy,HTO)与单髁置换术(unicompartmental knee arthroplasty,UKA)治疗单间室骨性关节炎的疗效。[方法]通过计算机检索建库至2017年9月PubMed、Embase、Cochrane Library、CBM、CNKI、万方数据库,查找所有比较胫骨高位截骨和单髁置换治疗膝关节单间室骨关节炎的临床对照试验,根据纳入与排除标准进行文献筛选、质量评价和数据提取后,应用Revman 5.3软件对各项评价指标进行Meta分析。[结果]共纳入16篇文献,共6 488例膝关节,其中1 025例HTO,5 463例UKA。Meta分析结果显示:HTO与UKA相比,优良率[OR=0.33,95%CI:(0.16,0.70),P=0.004]、术后并发症[OR=3.07,95%CI:(1.78,5.31),P<0.001]、术后疼痛[OR=0.34,95%CI:(0.19,0.59),P<0.001]、术后关节活动度[MD=6.94,95%CI:(1.58,12.30),P=0.010]差异有统计学意义,返修率、术后膝关节评分、术后行走速度、术后股骨胫骨角差异无统计学意义。[结论]UKA相对HTO存在术后优良率较高、术后并发症较少的优势,HTO在术后疼痛及关节活动度上有优势;翻修率、膝关节评分、行走速度、股骨胫骨角HTO与UKA基本相似。但限于纳入文献的数量和质量,上述结论仍需更多大样本、高质量的RCT研究进一步论证。

引用

页码：814 / 820

页数：7

共 10 条

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