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固定平台与活动平台单髁膝关节置换术的比较:系统评价和荟萃分析。

Comparison of Fixed-Bearing and Mobile-Bearing Unicompartmental Knee Arthroplasty: A Systematic Review and Meta-Analysis.

机构信息

Department of Orthopedics, Shenzhen Pingle Orthopedic Hospital, Shenzhen, Guangdong, People's Republic of China.

Department of Orthopedics, Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, Guangdong, People's Republic of China.

出版信息

J Arthroplasty. 2019 Dec;34(12):3114-3123.e3. doi: 10.1016/j.arth.2019.07.005. Epub 2019 Jul 30.

Abstract

BACKGROUND

Prior studies have compared fixed-bearing unicompartmental knee arthroplasty (FB-UKA) with mobile-bearing UKA (MB-UKA), suggesting that both procedures have good clinical outcomes. However, which treatment is more beneficial for patients is controversial. The purpose of our study is to evaluate the postoperative outcomes, including the revision rate, complications, functional results, range of motion, and femoral-tibial angle, between the 2 procedures.

METHODS

We searched the MEDLINE, EMBASE, Cochrane Library, and Web of Science databases starting from August 2017 to May 2018. The publication date of articles was not restricted. Before we submit our contribution, we have re-searched it again. Articles that directly compared the postoperative outcomes of the 2 prosthesis type were included.

RESULTS

A total of 15 comparative studies were included in our meta-analysis. The pooled data indicated no differences between the 2 operation modes in terms of revision rates, complications, and knee function, but earlier failure occurred more frequently with the MB design.

CONCLUSION

Both the arthroplasty types provided satisfactory clinical results for patients with classic indications. However, MB-UKA tended to fail in early postoperative years whereas fixed-bearing UKA in later postoperative years. Therefore treatment options should be carefully considered for each patient, and surgeons should still use their personal experience when deciding between these options.

摘要

背景

先前的研究比较了固定平台单髁膝关节置换术(FB-UKA)与活动平台单髁膝关节置换术(MB-UKA),表明这两种手术都有良好的临床效果。然而,哪种治疗方法对患者更有益仍存在争议。我们研究的目的是评估这两种手术的术后结果,包括翻修率、并发症、功能结果、活动范围和股骨-胫骨角。

方法

我们从 2017 年 8 月到 2018 年 5 月在 MEDLINE、EMBASE、Cochrane 图书馆和 Web of Science 数据库中进行了检索。文章的出版日期不受限制。在提交我们的贡献之前,我们再次进行了检索。包含这两种假体类型术后结果直接比较的文章被纳入。

结果

我们的荟萃分析共纳入了 15 项比较研究。汇总数据表明,在翻修率、并发症和膝关节功能方面,两种手术方式没有差异,但 MB 设计的早期失败更为常见。

结论

对于具有典型适应证的患者,这两种关节置换类型都能提供满意的临床效果。然而,MB-UKA 在术后早期更容易失败,而固定平台 UKA 在术后晚期更容易失败。因此,应根据每位患者的具体情况仔细考虑治疗选择,并且在选择这些选择时,外科医生仍应运用自己的个人经验。

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