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中华关节外科杂志(电子版) ›› 2020, Vol. 14 ›› Issue (04) : 461 -468. doi: 10.3877/cma.j.issn.1674-134X.2020.04.012

所属专题: 文献

荟萃研究

单半径和多半径后稳定型膝关节假体疗效的Meta分析
彭正午1, 王波1, 黄添隆1, 毛新展1, 李辉1,()   
  1. 1. 410011 长沙,中南大学湘雅二医院
  • 收稿日期:2020-01-05 出版日期:2020-08-01
  • 通信作者: 李辉

Meta-analysis on outcome of single- versus multi-radius posterior stabilized prostheses in total knee arthroplasty

Zhengwu Peng1, Bo Wang1, Tianlong Huang1, Xinzhan Mao1, Hui Li1,()   

  1. 1. The second Xiangya hospital, Changsha 410011, China
  • Received:2020-01-05 Published:2020-08-01
  • Corresponding author: Hui Li
  • About author:
    Corresponding author: Li Hui, Email:
引用本文:

彭正午, 王波, 黄添隆, 毛新展, 李辉. 单半径和多半径后稳定型膝关节假体疗效的Meta分析[J/OL]. 中华关节外科杂志(电子版), 2020, 14(04): 461-468.

Zhengwu Peng, Bo Wang, Tianlong Huang, Xinzhan Mao, Hui Li. Meta-analysis on outcome of single- versus multi-radius posterior stabilized prostheses in total knee arthroplasty[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2020, 14(04): 461-468.

目的

比较单半径(SR)和多半径(MR)后稳定型假体在全膝关节置换(TKA)术后的临床疗效。

方法

对荷兰医学文摘(Embase),Web of Science和Cochrane临床对照试验中心注册库4个数据库进行检索,选择使用单半径(SR)和多半径(MR)后稳定型假体作为初次膝关节置换的随机对照研究提取相关资料。采用RevMan 5.3软件对纳入数据进行异质性检验和Meta分析。

结果

最终纳入7篇随机对照试验文献(RCTs),共667位患者、667例膝关节置换。结果显示:SR与MR假体术后随访的膝关节评分系统的功能评分、膝关节牛津评分、活动度、屈曲度、站立位最小屈曲度、并发症等结果的差异无统计学意义(P>0.05)。而SR全膝关节置换术术后膝关节评分系统的膝关节评分和站立位最大屈曲度优于MR假体,差异具有统计学意义(I2=1%,Z=2.03,P < 0.05)。

结论

SR和MR后稳定型假体在膝关节置换中的术后临床效果无明显差异,但SR假体的术后膝关节评分系统的膝关节评分和站立位最大屈曲度要优于MR。

Objective

To compare single radius(SR) and multi radius(MR) femoral posterior stabilized prostheses in total knee arthroplasty(TKA).

Methods

The articles about TKA treated by SR and MR were searched in PubMed, Web of Science, the Cochrane Central Register of Controlled Trials (the Cochrane Central Register) and Excerpta Medica Database (Embase). The databases from a randomized controlled trials using SR and MR femoral posterior stabilized prostheses in firstly TKA were selected. The meta-analysis and heterogeneity test were performed with RevMan 5.3 software.

Results

Seven randomized controlled trials (RCTs) reporting 667 patients underwent total knee replacements were included in current study. The outcomes of this meta-analysis indicated that there were no significant statistical difference in Knee Society scores of functions, the range of motion, the flexion, the min flexion in stance phase and the complications between SR and MR TKA(P>0.05). The Knee Society scores of knee and max flexion in stance phase of SR were better than MR(I2=1%, Z=2.03, P<0.05).

Conclusion

No significant clinical difference is found between SR and MR posterior stabilized prostheses in TKA, but the Knee Society scores of knee and the max flexion in stance phase of SR are better than MR.

图1 文献筛选流程图
图2 随机对照试验的偏倚风险图
表1 Meta分析中所包含文献的基本资料
图3 SR(单半径)和MR(多半径)假体TKA(全膝关节置换)术后评分的森林图。图A为SR和MR假体TKA术后KSS(膝关节协会评分)比较的森林图;图B为SR和MR假体TKA术后KSS比较的森林图(敏感性分析后);图C为SR和MR假体TKA术后OKS(牛津膝关节评分)比较的森林图;SD(标准差);IV(逆方差);CI(置信区间);df(自由度)
图4 SR(单半径)和MR(多半径)假体TKA(全膝关节置换)术后KSSF(膝关节功能评分)比较的森林图。SD(标准差);IV(逆方差);CI(置信区间);df(自由度)
图5 SR(单半径)和MR(多半径)假体TKA(全膝关节置换)术后活动度、站立位最大屈曲度和摆动位最大屈曲度比较森林图;SD(标准差);IV(逆方差);CI(置信区间);df(自由度)
图6 SR(单半径)和MR(多半径)假体TKA(全膝关节置换)术后屈曲度及站立位最小屈曲度比较的森林图;SD(标准差);IV(逆方差);CI(置信区间);df(自由度)
图7 单半径和多半径假体TKA术后并发症比较的森林图;RR(风险率);IV(逆方差);CI(置信区间);df(自由度)
图8 SR和MR组术后KSFS比较漏斗图。KSFS(膝关节评分系统的膝关节评分)
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