无结倒刺缝线在全关节置换术中的疗效与安全性：一项随机对照试验的荟萃分析

The efficacy and safety of knotless barbed sutures in total joint arthroplasty: a meta-analysis of randomized-controlled trials.

作者信息

Han Yanhong, Yang Weiyi, Pan Jianke, Zeng Lingfeng, Liang Guihong, Lin Jiongtong, Luo Minghui, Guo Da, Liu Jun

机构信息

Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China.

Bone and Joint Research Team of Degeneration and Injury, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120, China.

出版信息

Arch Orthop Trauma Surg. 2018 Oct;138(10):1335-1345. doi: 10.1007/s00402-018-2979-9. Epub 2018 Jun 16.

BACKGROUND

The knotless barbed sutures (KBS) are an innovative type of suture that can accelerate the placement of sutures and eliminate knot tying. Whether the KBS are safe and efficient in total joint arthroplasty (TJA) remains controversial. Therefore, we conducted a meta-analysis to evaluate its efficacy and safety.

METHODS

Randomized-controlled trials (RCTs) were identified from the PubMed, Embase, and Cochrane Library databases up to October 2017. The Cochrane risk of bias tool was used to assess methodological quality. The statistical analysis was performed with RevMan 5.3.5 software.

RESULTS

A total of five RCTs (600 participants) were included in our meta-analysis. The results showed that KBS reduced wound suture time (MD - 4.51, 95% CI - 5.37 to - 3.66, P < 0.00001) and the wound suture cost (MD - 282.63, 95% CI - 445.32 to - 119.95, P < 0.00001), and did not significantly increase the rate of complications (OR 0.77, 95% CI 0.42-1.39, P = 0.13) or intraoperative events (OR 0.86, 95% CI 0.04-17.28, P = 0.92). There were no significant differences in ROM at postoperative 6 weeks and 3 months (MD - 0.74, 95% CI - 4.19 to 2.71, P = 0.67; MD - 0.30, 95% CI - 2.62 to 2.02, P = 0.80; respectively).

CONCLUSION

Our findings suggest that KBS are a safe and effective method for TJA. Given the possible biases, adequately powered and better designed studies with longer follow-up are required to reach a firmer conclusion.

背景

免打结倒刺缝线（KBS）是一种创新型缝线，可加快缝线置入速度并省去打结步骤。在全关节置换术（TJA）中，KBS是否安全有效仍存在争议。因此，我们进行了一项荟萃分析以评估其疗效和安全性。

方法

截至2017年10月，从PubMed、Embase和Cochrane图书馆数据库中检索随机对照试验（RCT）。采用Cochrane偏倚风险工具评估方法学质量。使用RevMan 5.3.5软件进行统计分析。

结果

我们的荟萃分析共纳入5项RCT（600名参与者）。结果显示，KBS缩短了伤口缝合时间（MD -4.51，95%CI -5.37至-3.66，P＜0.00001）和伤口缝合成本（MD -282.63，95%CI -445.32至-119.95，P＜0.00001），且未显著增加并发症发生率（OR 0.77，95%CI 0.42 - 1.39，P = 0.13）或术中事件发生率（OR 0.86，95%CI 0.04 - 17.28，P = 0.92）。术后6周和3个月时的关节活动度（ROM）无显著差异（分别为MD -0.74，95%CI -4.19至2.71，P = 0.67；MD -0.30，95%CI -2.62至2.02，P = 0.80）。