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自体骨移植与骨替代物手术治疗胫骨平台骨折的Meta分析
Hits: 832   Download times: 366   Received:December 09, 2022    
作者Author单位UnitE-Mail
郭华 GUO Hua 山西医科大学第二医院骨科, 山西 太原 030001
山西省骨与软组织损伤修复重点实验室, 山西 太原 030001
Department of Orthopaedics, second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China
Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan 030001, Shanxi, China
 
黄凌岸 HUANG Ling-an 山西医科大学第二医院骨科, 山西 太原 030001
山西省骨与软组织损伤修复重点实验室, 山西 太原 030001
海南医学院三亚中心医院疼痛医学科, 海南 三亚 572000
Department of Orthopaedics, second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China
Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan 030001, Shanxi, China
Department of Pain Medicine, Sanya Central Hospital of Hainan Medical College, Sanya 572000, Hainan, China
 
李皓乾 LI Hao-qian 山西医科大学第二医院骨科, 山西 太原 030001
山西省骨与软组织损伤修复重点实验室, 山西 太原 030001
Department of Orthopaedics, second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China
Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan 030001, Shanxi, China
 
郭丽 GUO Li 山西医科大学第二医院骨科, 山西 太原 030001
山西省骨与软组织损伤修复重点实验室, 山西 太原 030001
Department of Orthopaedics, second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China
Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan 030001, Shanxi, China
 
李鹏翠 LI Peng-cui 山西医科大学第二医院骨科, 山西 太原 030001
山西省骨与软组织损伤修复重点实验室, 山西 太原 030001
Department of Orthopaedics, second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China
Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan 030001, Shanxi, China
 
卫小春 WEI Xiao-chun 山西医科大学第二医院骨科, 山西 太原 030001
山西省骨与软组织损伤修复重点实验室, 山西 太原 030001
Department of Orthopaedics, second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China
Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan 030001, Shanxi, China
sdeygksys@163.com 
期刊信息:《中国骨伤》2024年37卷,第3期,第300-305页
DOI:10.12200/j.issn.1003-0034.20220937
基金项目:国家自然科学基金区域联合重点资助项目(编号:U21A20353);山西省基础研究计划自然科学研究面上项目(编号:20210302123285)


目的:通过Meta分析系统评价自体骨移植和骨替代物治疗胫骨平台骨折的临床疗效。

方法:计算机检索2005年1月至2022年8月PubMed、Web of Science、中国知网、万方等数据库已发表的关于自体骨移植和骨替代物治疗胫骨平台骨折的病例对照研究文献。根据纳排标准进行文献筛选及数据提取,对入选的随机对照研究(randomized controlled trial,RCT)采用Cochrane手册中的干预性Meta分析标准进行质量评价。采用 RevMan 5.3 软件对两种方法的关节凹陷、关节面二次塌陷率、失血量、手术时间和感染率进行Meta 分析。

结果:共纳入7项RCT研究,424例患者,其中骨替代物组296例,自体骨移植组128例。两组手术时间[MD=-16.79,95%CI(-25.72,-7.85),P=0.000 2],出血量[MD=-70.49,95%CI(-79.34,-61.65),P<0.000 01]比较,差异有统计学意义。而关节凹陷[MD=-0.17,95%CI(-0.91, 0.58),P=0.66],关节面二次塌陷率[RR=-0.74,95%CI(0.35,1.57),P=0.43],感染率[RR=1.21,95%CI(0.31,4.70),P=0.78]比较,差异无统计学意义。

结论:骨替代物与自体骨移植治疗胫骨平台骨折在关节凹陷、关节面二次塌陷率和感染率方面疗效相近。但骨替代物较自体骨移植,能减少失血量,缩短手术时间。
[关键词]:胫骨平台骨折  自体骨移植  骨替代物  Meta分析
 
Meta-analysis of autologous bone grafts and bone substitute for the treatment of tibial plateau fractures
Abstract:

Objective To explore clinical efficacy of autologous bone grafts and bone substitute for the treatment of tibial plateau fractures by Meta analysis.

Methods Controlled clinical studies on autogenous bone transplantation and bone substitutes in treating tibial plateau fractures published on PubMed,Web of Science,CNKI,Wanfang and other databases from January 2005 to August 2022 were searched by computer. Literature screening and data extraction were performed according to randomized controlled trial(RCT),and the quality of RCT were evaluated by using intervention meta-analysis criteria in Cochrane manual. Meta-analysis of joint depression,secondary collapse rate of articular surface,blood loss,operative time and infection rate between two methods were performed by Rev Man 5.3 software.

Results Seven RCT studies (424 patients) were included,296 patients in bone replacement group and 128 patients in autograft group. Operative time[MD=-16.79,95%CI(-25.72,-7.85),P=0.000 2] and blood loss[MD=-70.49,95%CI(-79.34,-61.65),P<0.000 01] between two groups had statistically differences,while joint depression[MD=-0.17,95%CI(-0.91,0.58),P=0.66],secondary collapse rate of joint surface[RR=-0.74, 95%CI(0.35,1.57),P=0.43],infection rate[RR=1.21,95%CI(0.31,4.70),P=0.78] between two groups had no differences.

Conclusion The effects of bone substitute and autograft for the treatment of tibial plateau fracture have similar effects in terms of joint depression,secondary articular surface collapse rate and infection rate. However,compared with autologous bone transplantation,bone replacement could reduce blood loss and shorten operation time.
KEYWORDS:Tibial plateau fracture  Autologous bone graft  Bone substitute  Meta-analysis
 
引用本文,请按以下格式著录参考文献:
中文格式:郭华,黄凌岸,李皓乾,郭丽,李鹏翠,卫小春.自体骨移植与骨替代物手术治疗胫骨平台骨折的Meta分析[J].中国骨伤,2024,37(3):300~305
英文格式:GUO Hua,HUANG Ling-an,LI Hao-qian,GUO Li,LI Peng-cui,WEI Xiao-chun.Meta-analysis of autologous bone grafts and bone substitute for the treatment of tibial plateau fractures[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(3):300~305
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