| 股四头肌与骨-髌腱-骨自体移植对前交叉韧带重建的Meta分析 |
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投稿时间：2020-01-07
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| 作者 | Author | 单位 | Address | E-Mail |
| 李飞 |
LI Fei |
山西医科大学第二医院骨科, 山西 太原 030001
山西医科大学骨与软组织损伤修复山西省重点实验室, 山西 太原 030001 |
Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China |
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| 顾晓东 |
GU Xiao-dong |
山西医科大学第二医院骨科, 山西 太原 030001
山西医科大学骨与软组织损伤修复山西省重点实验室, 山西 太原 030001 |
Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China |
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| 卫小春 |
WEI Xiao-chun |
山西医科大学第二医院骨科, 山西 太原 030001
山西医科大学骨与软组织损伤修复山西省重点实验室, 山西 太原 030001 |
Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China |
sdeygksys@163.com |
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| 期刊信息：《中国骨伤》2020年，第33卷，第7期，第677-683页 |
| DOI：10.12200/j.issn.1003-0034.2020.07.018 |
| 基金项目: |
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中文摘要:
目的： 通过Meta分析比较股四头肌与骨-髌腱-骨自体移植对前交叉韧带重建手术疗效的影响。
方法： 计算机检索建库至2019年5月PubMed、EMbase、Cochrane图书馆、万方数据库和中国知网发表的比较股四头肌、骨-髌腱-骨自体移植物的病例对照研究文献，根据纳入与排除标准进行文献筛选、质量评价及数据提取，采用Review Manager 5.3统计学软件对患膝与健膝前向移位差值、Lachman试验、轴移试验、Lysholm评分、IKDC（International Knee Documentation Committee）客观等级、膝前疼痛和移植失败率进行Meta分析。
结果： 共纳入6篇文献，915例患者，其中股四头肌自体移植495例，骨-髌腱-骨自体移植420例。Meta分析结果显示：股四头肌自体移植与骨-髌腱-骨自体移植在胫骨向前移位差值>3 mm[OR=1.53，95% CI（0.68，3.44），P=0.31]，3~5 mm[OR=0.64，95% CI（0.31，1.35），P=0.24]，>5 mm[OR=1.18，95% CI（0.33，4.22），P=0.80]，Lachman试验阴性率[OR=0.88，95% CI（0.38，2.02），P=0.76]，轴移试验阴性率[OR=0.63，95% CI（0.24，1.68），P=0.36]方面比较差异无统计学意义。两组在Lyshlom评分[MD=-0.56，95% CI（-2.00，0.89），P=0.45]，IKDC客观等级A或B级[OR=0.87，95% CI（0.47，1.60），P=0.66]及移植失败率[OR=0.76，95% CI（0.28，2.02），P=0.58]方面比较差异无统计学意义；在减少膝前疼痛方面，股四头肌自体移植优于骨-髌腱-骨自体移植[OR=0.16，95% CI（0.09，0.29），P<0.000 01]。
结论： 股四头肌自体移植的临床和功能结果以及移植物存活率与骨-髌腱-骨自体移植相当，且股四头肌自体移植可以明显减少膝前疼痛。对于前交叉韧带重建患者，股四头肌自体移植可作为前交叉韧带重建合适的移植替代物。 |
| 【关键词】四头肌 骨-髌腱-骨移植物 前交叉韧带重建 Meta分析 |
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| Outcomes of quadriceps tendon autograft versus bone-patellar tendon-bone autograft for anterior cruciate ligament reconstruction: a Meta-analysis |
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ABSTRACT
Objective: To evaluate clinical effect of quadriceps tendon autograft and bone-patellar tendon-bone autograft on anterior cruciate ligament reconstruction by Meta-analysis.
Methods: From the time of building databases to May 2019,literatures on case-control study on quadriceps tendon and bone-patellar tendon-bone autograft on anterior cruciate ligament reconstruction were searched form PubMed,EMbase,the Cochrane library,Wanfang and CNKI database. Literature screening,quality evaluation and data extraction were carried out according to include and exclude standard. Difference of forward displacement between the affected and health knee,Lachman test,axial shift test,Lysholm score,international knee documentation committee(IKDC) objective grade,anterior knee joint pain and transplant failure rate were analyzed by Meta analysis.
Result: Totally 6 literatures were included,including 915 patients with anterior cruciate ligament reconstruction,495 patients with quadriceps tendon autograft and 420 patients with bone-patellar tendon-bone autograft. There were no statistical differences in anterior displacement of tibia was less than 3 mm[OR=1.53,95%CI(0.68,3.44),P=0.31],3 to 5 mm[OR=0.64,95%CI(0.31,1.35),P=0.24],greater than 5 mm[OR=1.18,95%CI(0.33,4.22),P=0.80],negative rate of Lachman test[OR=0.88,95%CI(0.38,2.02),P=0.76],negative rate of axial shift test[OR=0.63,95%CI(0.24,1.68),P=0.36] between two groups. There were no differences in Lyshlom score[MD=-0.56,95%CI(-2.00,0.89),P=0.45],IKDC objective grade A and B[OR=0.87,95%CI(0.47,1.60),P=0.66],and transplant failure rate[OR=0.76,95%CI(0.28,2.02),P=0.58]. In reducing anterior knee pain,quadriceps tendon autograft was better than that of bone-patellar tendon-bone autograft[OR=0.16,95%CI(0.09,0.29),P<0.000 01].
Conclusion: Quadriceps tendon autograft and bone-patellar tendon-bone autograft on anterior cruciate ligament reconstruction has equal clinical and functional outcomes,transplant failure rate,quadriceps tendon autograft could reduce anterior knee pain. For patients with anterior cruciate ligament reconstruction,quadriceps tendon autograft could be seen as suitable alternative bone graft substitutes for anterior cruciate ligament reconstruction. |
| KEY WORDS Quadriceps muscle Bone-patellar tendon-bone grafts Anterior cruciate ligament reconstruction Meta-analysis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李飞,顾晓东,卫小春.股四头肌与骨-髌腱-骨自体移植对前交叉韧带重建的Meta分析[J].中国骨伤,2020,33(7):677~683 |
| 英文格式: | LI Fei,GU Xiao-dong,WEI Xiao-chun.Outcomes of quadriceps tendon autograft versus bone-patellar tendon-bone autograft for anterior cruciate ligament reconstruction: a Meta-analysis[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(7):677~683 |
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