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初次全膝关节置换术中单半径与多半径股骨假体功能结局的比较:一项随机对照试验的荟萃分析

Comparison of functional outcomes between single-radius and multi-radius femoral components in primary total knee arthroplasty: a meta-analysis of randomized controlled trials.

作者信息

Kim Jahyung, Min Kyung-Dae, Lee Byung-Ill, Kim Jun-Bum, Kwon Sai-Won, Chun Dong-Il, Kim Yong-Beom, Seo Gi-Won, Lee Jeong Seok, Park Suyeon, Choi Hyung-Suk

机构信息

Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, 59, Daesagwan-ro, Yongsan-gu, Seoul, 04401, South Korea.

Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, Bucheon, South Korea.

出版信息

Knee Surg Relat Res. 2020 Oct 2;32(1):52. doi: 10.1186/s43019-020-00067-y.

Abstract

PURPOSE

Our purpose in the current meta-analysis was to compare the functional outcomes in patients who have received single-radius (SR) or multi-radius (MR) femoral components in randomized controlled trials (RCTs) for primary total knee arthroplasty (TKA). The hypothesis was that there would be no statistically significant difference between two groups in terms of functional outcomes.

MATERIALS AND METHODS

We searched the international electronic databases PubMed, Embase, and the Cochrane Central Register of Controlled Trials up to February 2020 for RCTs that compared functional outcomes of SR and MR femoral component designs after primary TKA. We performed a meta-analysis of nine RCTs using the Knee Society Score for the knee (KSS-knee), KSS-function, Knee Injury and Osteoarthritis Outcome Score (KOOS), Oxford Knee Score (OKS), degree of knee flexion, extension, and complications, including postoperative infection and revision surgery.

RESULTS

The meta-analysis revealed no statistically significant differences in all the analyzed variables, including KSS-knee, KSS-function, KOOS, OKS, knee flexion, and knee extension. For postoperative complications, no statistically significant differences were detected for femoral component designs in postoperative infection or incidence of revision surgery between the two groups.

CONCLUSIONS

The current meta-analysis of RCTs did not show any statistically significant differences between SR and MR femoral component designs in terms of postoperative functional outcomes. Evaluated outcomes included functional outcome scores, degree of knee flexion, extension, and complications. However, because of the limited clinical evidence of this study owing to the heterogeneity between the included RCTs, a careful approach should be made in order not to arrive at definite conclusions.

摘要

目的

在本次荟萃分析中,我们旨在比较在初次全膝关节置换术(TKA)的随机对照试验(RCT)中接受单半径(SR)或多半径(MR)股骨组件的患者的功能结局。假设是两组在功能结局方面不存在统计学上的显著差异。

材料与方法

我们检索了截至2020年2月的国际电子数据库PubMed、Embase和Cochrane对照试验中央注册库,以查找比较初次TKA后SR和MR股骨组件设计功能结局的RCT。我们使用膝关节协会膝关节评分(KSS-膝关节)、KSS-功能评分、膝关节损伤和骨关节炎结局评分(KOOS)、牛津膝关节评分(OKS)、膝关节屈曲度、伸展度以及并发症(包括术后感染和翻修手术)对9项RCT进行了荟萃分析。

结果

荟萃分析显示,在所有分析变量中均无统计学上的显著差异,包括KSS-膝关节、KSS-功能评分、KOOS、OKS、膝关节屈曲和膝关节伸展。对于术后并发症,两组之间在术后感染或翻修手术发生率方面,股骨组件设计未检测到统计学上的显著差异。

结论

本次对RCT的荟萃分析未显示SR和MR股骨组件设计在术后功能结局方面存在任何统计学上的显著差异。评估的结局包括功能结局评分、膝关节屈曲度、伸展度和并发症。然而,由于纳入的RCT之间存在异质性,本研究的临床证据有限,因此应谨慎对待,以免得出明确结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0813/7531164/829bbd55fe31/43019_2020_67_Fig1_HTML.jpg

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