Sun Luping, Huang Zhidan
The Fifth Central Hospital of Tianjin, China.
The People's Hospital of Puning, Pharmaceutical University, China.
Appl Bionics Biomech. 2022 Apr 18;2022:4277563. doi: 10.1155/2022/4277563. eCollection 2022.
To evaluate the efficacy and adverse reactions of arthroscopic half-moon plate invasive surgery (DEB) in patients with knee pain (AKP) using meta-analysis techniques.
The computer retrieves from the English databases PubMed, EMBASE, Cochrane Library, and Web of Science and the Chinese databases China Knowledge Network, Wanfang Database, VIP Database, and China Biomedical Literature Database to collect information about DEB therapeutic AKP randomized controlled trial. Develop criteria for documentation inclusion and exclusion, evaluate the quality and bias risk of literature, and compare differences in efficacy and adverse responses before and after DEB treatment and other conservative treatments.
A total of 14 randomized controlled trials and 1464 AKP patients were included in the study, with follow-up duration of 1-12 months. The total knee scores for DEB at 1, 3, 6, and 12 months after treatment were significantly better than baseline levels (1 month: WMD = 34.56, = 0.02; 3 months: WMD = 27.73, = 0.0001; 6 months: SMD = 2.38, = 0.0001; 12 months: SMD = 1.69, = 0.001). At 6 months of follow-up, DEB improved knee function better than HA (SMD = 0.47, = 0.003), and during follow-up for 12 months, DEB relieved knee pain (SMD = 0.55, = 0.0007) and improved knee function (SMD = 0.88, = 0.0001) which is significantly better than HA. DEB was less effective at improving knee function in 1, 3, and 12 months than DEB joint HA injections (1 month = 004; 3 months = 0.01; 12 months = 0.03). At 6 and 12 months of follow-up, DEB was better at pain relief and improved function than ozone ( > 0.05). DEB and glucocorticosteroids have similar effects in pain relief and improved function at various follow-up times. In terms of adverse reactions, DEB does not increase the risk of adverse events compared to HA (OR = 0.96, = 0.85).
Compared to HA and ozone, DEB is a more effective treatment for AKP joints, while DEB is combined with HA. The clinical efficacy of injection therapy AKP is better than that of DEB alone.
采用荟萃分析技术评估关节镜下半月板侵入性手术（DEB）治疗膝关节疼痛（AKP）患者的疗效及不良反应。
通过计算机检索英文数据库PubMed、EMBASE、Cochrane图书馆和Web of Science以及中文数据库中国知网、万方数据库、维普数据库和中国生物医学文献数据库，收集关于DEB治疗AKP的随机对照试验信息。制定文献纳入和排除标准，评估文献质量和偏倚风险，并比较DEB治疗前后及其他保守治疗在疗效和不良反应方面的差异。
本研究共纳入14项随机对照试验和1464例AKP患者，随访时间为1至12个月。治疗后1、3、6和12个月时，DEB的膝关节总评分显著优于基线水平（1个月：加权均数差[WMD]=34.56，P=0.02；3个月：WMD=27.73，P=0.0001；6个月：标准化均数差[SMD]=2.38，P=0.0001；12个月：SMD=1.69，P=0.001）。随访6个月时，DEB改善膝关节功能优于透明质酸（HA）（SMD=0.47，P=0.003）；随访12个月期间，DEB缓解膝关节疼痛（SMD=0.55，P=0.0007）和改善膝关节功能（SMD=0.88，P=0.0001）均显著优于HA。在1、3和12个月时，DEB改善膝关节功能的效果不如DEB联合HA注射（1个月P=0.04；3个月P=0.01；12个月P=0.03）。随访6个月和12个月时，DEB在缓解疼痛和改善功能方面优于臭氧（P>0.05）。在各随访时间点，DEB和糖皮质激素在缓解疼痛和改善功能方面效果相似。在不良反应方面，与HA相比，DEB未增加不良事件风险（比值比[OR]=0.96，P=0.85）。
与HA和臭氧相比，DEB是治疗AKP关节更有效的方法，而DEB联合HA时，注射治疗AKP的临床疗效优于单纯DEB。
