高屈曲度全膝关节置换术无临床益处：一项随机对照试验的荟萃分析

No clinical benefit of high-flex total knee arthroplasty. A meta-analysis of randomized controlled trials.

作者信息

Fu Huichao, Wang Jiaxing, Zhang Wen, Cheng Tao, Zhang Xianlong

机构信息

Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.

出版信息

J Arthroplasty. 2015 Apr;30(4):573-9. doi: 10.1016/j.arth.2014.10.032. Epub 2014 Nov 10.

DOI:10.1016/j.arth.2014.10.032

PMID:25468780

Abstract

The application of high-flex prosthesis in total knee arthroplasty (TKA) is an area of continuing debate. Thus, we conducted a meta-analysis of randomized controlled trials (RCTs). A literature search was performed in PubMed, EMBASE and the Cochrane database. 10 trials involving 1230 knee joints were eligible for our meta-analysis. No significant difference was observed between the two designs regarding postoperative range of flexion, clinical scores, quality of life outcomes, or complication rate. Moreover, the advantage of high-flex implants for patients with high preoperative range remained not statistically significant and high-flex design in NexGen system showed a marginal improvement in the postoperative range of flexion. Based on current findings, high-flex prosthesis did not appear to confer any benefit as compared to standard prosthesis.

摘要

高屈曲假体在全膝关节置换术（TKA）中的应用一直是一个备受争议的领域。因此，我们对随机对照试验（RCT）进行了一项荟萃分析。在PubMed、EMBASE和Cochrane数据库中进行了文献检索。10项涉及1230个膝关节的试验符合我们的荟萃分析标准。在术后屈曲范围、临床评分、生活质量结果或并发症发生率方面，两种设计之间未观察到显著差异。此外，对于术前屈曲范围较大的患者，高屈曲植入物的优势在统计学上也不显著，并且NexGen系统中的高屈曲设计在术后屈曲范围方面仅显示出轻微改善。基于目前的研究结果，与标准假体相比，高屈曲假体似乎并没有带来任何益处。