动态关节内韧带稳定技术治疗前交叉韧带撕裂的临床疗效：荟萃分析。
Clinical outcomes in dynamic intraligamentary stabilization technique for anterior cruciate ligament tear: A meta-analysis.
机构信息
Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, Hunan, China.
出版信息
Medicine (Baltimore). 2023 Mar 10;102(10):e33091. doi: 10.1097/MD.0000000000033091.
BACKGROUND
To compare the clinical outcome between dynamic intraligamentary stabilization (DIS) and anterior cruciate ligament (ACL) reconstruction in ACL tears.
METHODS
PubMed, the Cochrane Library, and Embase databases were searched to identify published articles on clinical studies comparing DIS versus ACL reconstruction. The results of the eligible studies were analyzed in terms of anteroposterior knee laxity translation (ΔATT) between the injured and contralateral knees, and subjective International Knee Documentation Committee (IKDC), Lysholm score, Tegner score, and ipsilateral ACL failure, implant removal, and ACL revision.
RESULTS
Five clinical studies including 429 patients with ACL tears met the inclusion criteria. DIS showed statistically comparable outcomes of ΔATT (P = .12), IKDC (P = .38), Tegner (P = .82), ACL failure (P = .50), ACL revision (P = .29) with ACL reconstruction. A significantly higher rate of implant removal (odds ratio for DIS vs ACL reconstruction, 7.73; 95% confidence interval [CI], 2.72-22.00; P = .0001) but statistically higher Lysholm score (mean difference between DIS and ACL reconstruction, 1.59; 95% CI, 0.24-2.93; P = .02) were found in DIS group.
CONCLUSION
Five clinical studies including 429 patients with ACL tears met the inclusion criteria. DIS showed statistically comparable outcomes of ΔATT (P = .12), IKDC (P = .38), Tegner (P = .82), ACL failure (P = .50), ACL revision (P = .29) with ACL reconstruction. A significantly higher rate of implant removal (odds ratio for DIS vs ACL reconstruction, 7.73; 95% CI, 2.72-22.00; P = .0001) but statistically higher Lysholm score (mean difference between DIS and ACL reconstruction, 1.59; 95% CI, 0.24-2.93; P = .02) were found in DIS group.
背景
比较动态节内稳定术（DIS）与前交叉韧带（ACL）重建治疗 ACL 撕裂的临床疗效。
方法
检索 PubMed、Cochrane 图书馆和 Embase 数据库，以确定比较 DIS 与 ACL 重建的临床研究的相关文献。根据受伤侧与对侧膝关节前后向松弛度（ΔATT）、国际膝关节文献委员会（IKDC）主观评分、Lysholm 评分、Tegner 评分以及同侧 ACL 失效、植入物取出和 ACL 翻修等方面对纳入研究的结果进行分析。
结果
纳入的 5 项临床研究共 429 例 ACL 撕裂患者符合纳入标准。与 ACL 重建相比，DIS 组的 ΔATT（P =.12）、IKDC（P =.38）、Tegner（P =.82）、ACL 失效（P =.50）、ACL 翻修（P =.29）的结果无统计学差异。但 DIS 组植入物取出率显著较高（DIS 与 ACL 重建的比值比，7.73；95%可信区间[CI]，2.72-22.00；P =.0001），Lysholm 评分显著较高（DIS 与 ACL 重建的平均差值，1.59；95%CI，0.24-2.93；P =.02）。
结论
纳入的 5 项临床研究共 429 例 ACL 撕裂患者符合纳入标准。与 ACL 重建相比，DIS 组的 ΔATT（P =.12）、IKDC（P =.38）、Tegner（P =.82）、ACL 失效（P =.50）、ACL 翻修（P =.29）的结果无统计学差异。但 DIS 组植入物取出率显著较高（DIS 与 ACL 重建的比值比，7.73；95%CI，2.72-22.00；P =.0001），Lysholm 评分显著较高（DIS 与 ACL 重建的平均差值，1.59；95%CI，0.24-2.93；P =.02）。
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