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单髁膝关节置换术后重返运动:一项系统评价与荟萃分析

Return to Sport After Unicompartmental Knee Arthroplasty: A Systematic Review and Meta-analysis.

作者信息

Radhakrishnan Ganan T, Magan Ahmed, Kayani Babar, Asokan Ajay, Ronca Flaminia, Haddad Fares S

机构信息

Department of Trauma and Orthopaedic Surgery, University College Hospital, London, UK.

Institute of Sports, Health and Exercise, University College Hospital, London, UK.

出版信息

Orthop J Sports Med. 2022 Mar 16;10(3):23259671221079285. doi: 10.1177/23259671221079285. eCollection 2022 Mar.

Abstract

BACKGROUND

Patients undergoing unicompartmental knee arthroplasty (UKA) often want to return to sport (RTS) after surgery. However, the time taken to RTS and proportion of patients who RTS after UKA remain unknown.

PURPOSE

To determine the time to RTS and proportion of patients who RTS after UKA.

STUDY DESIGN

Systematic review; Level of evidence, 4.

METHODS

A search was performed using PubMed, Medline, Embase, SPORTDiscus and the Cochrane Library databases for clinical trials reporting on RTS after UKA published between database inception and September 2021. In addition, a manual search was performed of relevant sports medicine and orthopaedic journals, and bibliographies were reviewed for eligible trials. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used to undertake this study.

RESULTS

This meta-analysis included 11 studies (749 patients) that reported on RTS after UKA. The proportion of patients returning to sports increased over time: 6 studies (432 patients) demonstrated an overall pooled proportion of 48.1% (95% CI, 36.3%-60.2%) of patients who returned to sport at 3 months after surgery, while 7 studies (443 patients) demonstrated an overall pooled proportion of 76.5% (95% CI, 63.9%-87.1%) of patients who returned to sport at 6 months after surgery. Overall, 92.7% (95% CI, 85.8%-97.4%) of 749 patients were able to RTS at 4 years after surgery. Overall excellent patient-reported functional outcomes scores and low risk of complications with RTS after UKA were reported.

CONCLUSION

The authors found that 48.1% of patients were able to RTS at 3 months after surgery and 76.5% were able to RTS at 6 months after UKA. Pooled proportion analysis showed that >90% of patients undergoing UKA were able to RTS at 48 months after surgery. The majority of patients who were able to RTS after UKA did so at a lower level of intensity than their preoperative level. RTS after UKA was associated with good patient-reported functional outcomes scores and a low risk of complications.

摘要

背景

接受单髁膝关节置换术(UKA)的患者术后通常希望恢复运动(RTS)。然而,UKA术后恢复运动所需的时间以及恢复运动的患者比例仍不明确。

目的

确定UKA术后恢复运动的时间以及恢复运动的患者比例。

研究设计

系统评价;证据等级,4级。

方法

使用PubMed、Medline、Embase、SPORTDiscus和Cochrane图书馆数据库进行检索,查找在数据库建立至2021年9月期间发表的关于UKA术后恢复运动的临床试验。此外,还对相关运动医学和骨科期刊进行了手工检索,并查阅了符合条件试验的参考文献目录。本研究采用PRISMA(系统评价和Meta分析的首选报告项目)指南。

结果

该Meta分析纳入了11项研究(749例患者),这些研究报告了UKA术后的恢复运动情况。恢复运动的患者比例随时间增加:6项研究(432例患者)显示,术后3个月恢复运动的患者总体合并比例为48.1%(95%CI,36.3%-60.2%),而7项研究(443例患者)显示,术后6个月恢复运动的患者总体合并比例为76.5%(95%CI,63.9%-87.1%)。总体而言,749例患者中有92.7%(95%CI,85.8%-97.4%)在术后4年能够恢复运动。报告显示,UKA术后患者报告的功能结局评分总体优秀,恢复运动后并发症风险较低。

结论

作者发现,48.1%的患者在术后3个月能够恢复运动,UKA术后6个月时76.5%的患者能够恢复运动。合并比例分析显示,接受UKA手术的患者中超过90%在术后48个月能够恢复运动。UKA术后能够恢复运动的大多数患者运动强度低于术前水平。UKA术后恢复运动与患者报告的良好功能结局评分以及较低的并发症风险相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d694/8935568/36ab40c77ffd/10.1177_23259671221079285-fig1.jpg

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