Department of Orthopedic, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China.
West China Hospital, Sichuan University, Chengdu, Sichuan, China.
PLoS One. 2023 May 2;18(5):e0285046. doi: 10.1371/journal.pone.0285046. eCollection 2023.
To compare the rerupture rate after conservative treatment, open repair, and minimally invasive surgery management of acute Achilles tendon ruptures.
Systematic review and network meta-analysis.
We searched Medline, Embase, and the Cochrane Central Register of Controlled Trials from inception to August 2022.
Randomised controlled trials involving different treatments for Achilles tendon rupture were included. The primary outcome was rerupture. Bayesian network meta-analysis with random effects was used to assess pooled relative risks (RRs) and 95% confidence intervals. We evaluated the heterogeneity and publication bias.
Thirteen trials with 1465 patients were included. In direct comparison, there was no difference between open repair and minimally invasive surgery for rerupture rate (RR, 0.72, 95% CI 0.10-4.4; I2 = 0%; Table 2). Compared to the conservative treatment, the RR was 0.27 (95% CI 0.10-0.62, I2 = 0%) for open repair and 0.14 (95% CI 0.01-0.88, I2 = 0%) for minimally invasive surgery. The network meta-analysis had obtained the similar results as the direct comparison.
Both open repair and minimally invasive surgery were associated with a significant reduction in rerupture rate compared with conservative management, but no difference in rerupture rate was found comparing open repair and minimally invasive surgery.
比较急性跟腱断裂保守治疗、开放修复和微创治疗后再断裂率。
系统评价和网络荟萃分析。
我们检索了 Medline、Embase 和 Cochrane 对照试验中心数据库，从建库到 2022 年 8 月。
纳入了不同治疗方法治疗跟腱断裂的随机对照试验。主要结局是再断裂。采用随机效应贝叶斯网络荟萃分析评估汇总相对风险（RR）和 95%置信区间。我们评估了异质性和发表偏倚。
纳入了 13 项共 1465 例患者的试验。直接比较中，开放修复与微创治疗的再断裂率无差异（RR，0.72，95%CI 0.10-4.4；I2 = 0%；表 2）。与保守治疗相比，开放修复和微创治疗的 RR 分别为 0.27（95%CI 0.10-0.62，I2 = 0%）和 0.14（95%CI 0.01-0.88，I2 = 0%）。网络荟萃分析得到了与直接比较相似的结果。
与保守治疗相比，开放修复和微创治疗均显著降低再断裂率，但开放修复和微创治疗之间的再断裂率无差异。
Zotero 插件
