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膝关节前交叉韧带解剖重建与前外侧韧带重建或不重建的比较:一项荟萃分析。

Anatomic reconstruction of the anterior cruciate ligament of the knee with or without reconstruction of the anterolateral ligament: A meta-analysis.

机构信息

Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, China.

出版信息

J Orthop Surg (Hong Kong). 2021 Jan-Apr;29(1):2309499020985195. doi: 10.1177/2309499020985195.

DOI:10.1177/2309499020985195
PMID:33410381
Abstract

PURPOSE

To systematically analyze the effectiveness between combined anterior cruciate ligament and anterolateral ligament reconstruction (ACL+ALLR) and isolated anterior cruciate ligament reconstruction (ACLR) for treatment of patients with injured ACL.

METHODS

We performed a systematic search in MEDLINE, EMBASE, PubMed, Web of Science, Cochrane databases, Chinese Biomedical Literature Database, CNKI, and Wanfang Data for all relevant studies. All statistical analysis was performed using Review Manager version 5.3.

RESULTS

A total of six articles with 460 study subjects were included, with 193 patients in ACL+ALL reconstruction group and 267 patients in ACL reconstruction group. The results of the meta-analysis showed that the ACL+ALL reconstruction group had significantly lower KT measured value (P < 0.00001), Lachman test positive-rate (P = 0.02), Pivot-shift test positive-rate (P < 0.00001) and graft rupture rate (P = 0.02) compared with the ACL reconstruction group. Higher IKDC score ( < 0.00001) and Lysholm score ( < 0.00001) were measured in ACL+ALL reconstruction group, while infection rate ( = 0.86) and other complications rate ( = 0.29) showed no significant differences between the two groups.

CONCLUSIONS

Anatomic reconstruction of the ACL of the knee with reconstruction of the ALL indicates better postoperative knee function and clinical outcomes compared with isolated ACL reconstruction. The infection rate and other complications rate showed no significant difference between two groups.

摘要

目的

系统分析前交叉韧带(ACL)联合前外侧韧带重建(ACL+ALLR)与单纯前交叉韧带重建(ACLR)治疗 ACL 损伤患者的疗效。

方法

我们在 MEDLINE、EMBASE、PubMed、Web of Science、Cochrane 数据库、中国生物医学文献数据库、CNKI 和万方数据中进行了系统检索,检索所有相关研究。所有统计分析均使用 Review Manager 版本 5.3 进行。

结果

共纳入 6 篇文章,460 例研究对象,ACL+ALL 重建组 193 例,ACL 重建组 267 例。Meta 分析结果显示,ACL+ALL 重建组的 KT 测量值(P < 0.00001)、Lachman 试验阳性率(P = 0.02)、前抽屉试验阳性率(P < 0.00001)和移植物断裂率(P = 0.02)明显低于 ACL 重建组。ACL+ALL 重建组的国际膝关节文献委员会(IKDC)评分( < 0.00001)和 Lysholm 评分( < 0.00001)较高,而感染率( = 0.86)和其他并发症发生率( = 0.29)两组间无显著差异。

结论

与单纯 ACL 重建相比,膝关节 ACL 解剖重建联合 ALL 重建可改善术后膝关节功能和临床结果。两组的感染率和其他并发症发生率无显著差异。

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