Zhao Zi-Qin, Xu Jin, Wang Rui-Lin, Xu Li-Na
Department of Pathology, Tianjin Hospital, No. 406 Jiefang South Road, Hexi District, Tianjin, 300211, People's Republic of China.
J Orthop Surg Res. 2018 Mar 12;13(1):51. doi: 10.1186/s13018-018-0752-y.
Many studies have proposed synovectomy during total knee arthroplasty (TKA) to reduce pain after TKA. The aim of this study was to assess the outcomes of synovectomy for treating of TKA through a meta-analysis.
Relevant clinical studies on synovectomy and without synovectomy were retrieved through searching the databases PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials up to January 2018. Studies that investigated the comparison of pain scores, total blood loss, range of motion, functional Knee Society Scores (KSSs), clinical KSSs, and operating time and provided sufficient data of interest were included in this meta-analysis. Stata 12.0 was used for meta-analysis.
Ten randomized controlled trials (RCTs) were finally included in this meta-analysis. Final results indicated that there was no significant difference between the pain scores, range of motion, functional Knee Society Scores (KSSs), and clinical KSSs (P > 0.05). However, synovectomy was associated with an increase of the total blood loss compared to patients without synovectomy (weighted mean difference (WMD) = 116.71, 95% confidence interval (CI) 78.63, 154.79, P = 0.000). Pooled results indicated that synovectomy was associated with an increase of the operating time (WMD = 15.44, 95% CI 2.67, 28.21, P = 0.018).
Current evidence indicates that synovectomy has no effects on the final clinical outcomes for patients undergoing TKA. It will increase the total blood loss and the operating time during TKA.
许多研究提出在全膝关节置换术(TKA)中进行滑膜切除术以减轻TKA术后疼痛。本研究旨在通过荟萃分析评估滑膜切除术治疗TKA的效果。
通过检索截至2018年1月的PubMed、Embase、Web of Science和Cochrane对照试验中央注册库等数据库,获取有关滑膜切除术和未进行滑膜切除术的相关临床研究。纳入本荟萃分析的研究需调查疼痛评分、总失血量、活动范围、膝关节功能评分(KSS)、临床KSS以及手术时间的比较,并提供足够的感兴趣数据。使用Stata 12.0进行荟萃分析。
本荟萃分析最终纳入了10项随机对照试验(RCT)。最终结果表明,疼痛评分、活动范围、膝关节功能评分(KSS)和临床KSS之间无显著差异(P>0.05)。然而,与未进行滑膜切除术的患者相比,滑膜切除术与总失血量增加有关(加权平均差(WMD)=116.71,95%置信区间(CI)78.63,154.79,P=0.000)。汇总结果表明,滑膜切除术与手术时间增加有关(WMD=15.44,95%CI 2.67,28.21,P=0.018)。
目前的证据表明,滑膜切除术对接受TKA的患者的最终临床结局没有影响。它会增加TKA期间的总失血量和手术时间。