| 活动平台与固定平台单髁置换治疗内侧膝骨关节炎的Meta分析 |
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投稿时间：2020-10-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 姜灵凯 |
JIANG Ling-kai |
山西医科大学第二医院骨科山西医科大学骨与软组织损伤修复山西重点实验室, 山西 太原 030001 |
Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China |
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| 魏垒 |
WEI Lei |
山西医科大学第二医院骨科山西医科大学骨与软组织损伤修复山西重点实验室, 山西 太原 030001 |
Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China |
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| 董政权 |
DONG Zheng-quan |
山西医科大学第二医院骨科山西医科大学骨与软组织损伤修复山西重点实验室, 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医科大学骨与软组织损伤修复山西重点实验室, 山西 太原 030001 |
Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China |
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| 李鹏翠 |
LI Peng-cui |
山西医科大学第二医院骨科山西医科大学骨与软组织损伤修复山西重点实验室, 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》2022年，第35卷，第1期，第67-75页 |
| DOI：10.12200/j.issn.1003-0034.2022.01.014 |
| 基金项目: |
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中文摘要:
目的：系统评价活动平台（mobile-bearing，MB）单室膝关节置换术（unicompartmental knee arthroplasty，UKA）与固定平台（fix-bearing，FB）UKA治疗膝骨关节炎的疗效。
方法：通过计算机检索2000年1月至2020年4月PubMed数据库，CNKI中国期刊全文数据库，万方数据库，Cochrane数据库，EMBASE数据库中的FB UKA与MB UKA治疗膝骨关节炎的相关文献。按照纳入与排除标准由2位作者独立筛选，并对选择纳入的文献进行质量评价。提取文献数据后，应用Review Manager 5.3软件分别对膝功能评分、术后活动度、翻修率、聚乙烯磨损率、衬垫脱位、无菌性松动、术后疼痛、膝骨关节炎进展、下肢机械轴矫正、影像学透亮线进行分析。
结果：此次Meta分析共纳入13篇文献，其中随机对照研究2篇，队列研究11篇。共1 871例患者，其中FB UKA组913例，MB UKA组958例。Meta分析结果显示：FB UKA组术后膝关节功能评分[MD=-0.84，95%CI（-1.46.-0.21），P=0.008]、术后膝关节活动度[MD=-1.51，95%CI（-2.84，-0.18），P=0.03]优于MB UKA组，MB UKA组相比于FB UKA组下肢机械轴对准率[OR=2.08，95%CI（1.27，3.39），P=0.003]较高，聚乙烯磨损率[OR=0.11，95%CI（0.01，0.91），P=0.04]较低，而两组在翻修率[OR=1.16，95%CI（0.75，1.80），P=0.50]，衬垫脱位率[OR=3.78，95%CI（0.93，15.29），P=0.06]，无菌性松动[OR=2.11，95%CI（0.81，5.51），P=0.13]，术后疼痛[OR=1.13，95%CI（0.37，3.43），P=0.83]，膝骨关节炎进展[OR=1.28，95%CI（0.67，2.47），P=0.46]，影像学透亮线[OR=1.62，95%CI（0.09，30.22），P=0.75]比较差异无统计学意义。
结论：FB UKA拥有更高的术后功能评分与活动度。而在下肢机械轴矫正方面MB UKA更具有优势，聚乙烯磨损率也更低。在翻修率、衬垫脱位、无菌性松动、术后疼痛、膝骨关节炎进展、术后透亮线方面两组差异无统计学意义。 |
| 【关键词】骨关节炎,膝 活动平台 固定平台 单髁置换 Meta分析 |
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| META analysis of mobile bearing and fixed bearing unicondyle replacement for medial knee osteoarthritis |
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ABSTRACT
Objective: To evaluate of the clinical effects of mobile-bearing(MB) and fixed-bearing(FB) unicompartmental knee arthroplasty(UKA) in the treatment of knee osteoarthritis by Meta-analysis.
Methods: The literature on FB UKA and MB UKA in the treatment of knee osteoarthritis in PubMed,CNKI,Wanfang,Cochrane and EMBASE database were searched by computer from January 2000 to April 2020. According to the inclusion and exclusion criteria,two authors were selected independently and the selected literature was evaluated for quality.After literature data were extracted,Review Manager 5.3 software was used to analyze knee function score,postoperative activity,revision rate,polyethylene wear rate,pad dislocation,aseptic loosening,postoperative pain,knee arthritis progression,mechanical shaft alignment of lower limbs,and imaging clarity line respectively.
Results: A total of 13 literatures were included in this meta-analysis,including 2 randomized controlled studies and 11 cohort studies. A total of 1 871 patients were included,including 913 in FB UKA group and 958 in MB UKA group. Meta analysis results showed that:postoperative knee joint function score[MD=-0.84,95%CI(-1.46,-0.21),P=0.008] and postoperative knee joint range of motion[MD=-1.51,95%CI(-2.84,-0.18),P=0.03] in FB UKA group were better than those in MB UKA group. Compared with FB UKA group,MB UKA group had a higher lower limb mechanical axis alignment rate[OR=2.08,95%CI(1.27,3.39),P=0.003],and the wear rate of polyethylene[OR=0.11,95%CI(0.01,0.91),P=0.04] was lower. There were no differences between two groups in the renovation rate[OR=1.16,95%CI(0.75,1.80),P=0.50),liner dislocation rate[OR=3.78,95%CI(0.93,15.29),P=0.06],aseptic loosening[OR=2.11,95%CI(0.81,5.51),P=0.13],postoperative pain[OR=1.13,95%CI(0.37,3.43),P=0.83],osteoarthritis progression[OR=1.28,95%CI(0.67,2.47),P=0.46)and imaging radiolucent line[OR=1.62,95%CI(0.09,30.22),P=0.75].
Conclusion: FB UKA has a higher postoperative functional score and range of motion. MB UKA has more advantages in the correction of lower limb mechanical axis,and the wear rate of polyethylene is also lower. There was no significant difference between the two groups in revision rate,dislocation of the liner,aseptic loosening,postoperative pain,progression of osteoarthritis,and postoperative translucency. |
| KEY WORDS Osteoarthritis,knee Mobile bearing Fixed bearing Unicondyle replacement 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: | 姜灵凯,魏垒,董政权,顾晓东,李鹏翠.活动平台与固定平台单髁置换治疗内侧膝骨关节炎的Meta分析[J].中国骨伤,2022,35(1):67~75 |
| 英文格式: | JIANG Ling-kai,WEI Lei,DONG Zheng-quan,GU Xiao-dong,LI Peng-cui.META analysis of mobile bearing and fixed bearing unicondyle replacement for medial knee osteoarthritis[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(1):67~75 |
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