患者特异性或常规器械：随机对照试验的荟萃分析。
Patient-Specific or Conventional Instrumentations: A Meta-analysis of Randomized Controlled Trials.
机构信息
Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China.
出版信息
Biomed Res Int. 2020 Mar 10;2020:2164371. doi: 10.1155/2020/2164371. eCollection 2020.
OBJECTIVE
To conduct a meta-analysis of randomized controlled trials (RCTs) to compare knee arthroplasty with patient-specific instrumentation (PSI) with the conventional instrumentation (CI).
METHODS
RCTs were selected in PubMed and Embase from 2012 to 2018. Key data extracted included malalignment of mechanical axis, blood loss, surgical time, Oxford Knee Score (OKS), Knee Society Score (KSS), length of stay, and complications. Subgroup analysis was also performed regarding different PSI systems and different image processing methods.
RESULTS
29 RCTs with 2487 knees were eligible for the meta-analysis. Results showed that PSI did not improve the alignment of the mechanical axis compared with CI, but MRI-based PSI and Visionaire-specific PSI decrease the risk of malalignment significantly ( = 0.04 and = 0.04 and = 0.04 and = 0.04 and = 0.04 and.
CONCLUSION
PSI reduced the blood loss and improved KSS. MRI-based PSI reduced operative time and risk of malalignment of mechanical axis compared with CT-based PSI. Moreover, Visionaire-specific PSI achieves better alignment result of the mechanical axis than other systems.
目的
对随机对照试验（RCT）进行荟萃分析，比较膝关节置换术与患者特异性仪器（PSI）和常规仪器（CI）。
方法
在 2012 年至 2018 年期间，从 PubMed 和 Embase 中选择 RCT。提取的关键数据包括机械轴对线不良、失血量、手术时间、牛津膝关节评分（OKS）、膝关节学会评分（KSS）、住院时间和并发症。还针对不同的 PSI 系统和不同的图像处理方法进行了亚组分析。
结果
29 项 RCT 共 2487 膝符合荟萃分析标准。结果表明，PSI 并没有比 CI 更能改善机械轴的对线，但是基于 MRI 的 PSI 和 Visionaire 专用 PSI 显著降低了对线不良的风险（ = 0.04 和 = 0.04 和 = 0.04 和 = 0.04 和 = 0.04 和.
结论
PSI 减少了失血量，改善了 KSS。与 CT 基 PSI 相比，基于 MRI 的 PSI 减少了手术时间和机械轴对线不良的风险。此外，Visionaire 专用 PSI 比其他系统获得更好的机械轴对线结果。
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