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开放式手术与内镜辅助松解治疗臀肌挛缩症的比较:系统评价和荟萃分析。

Comparison of open surgery versus endoscopic-assisted release for gluteal muscle contracture: a systematic review and meta-analysis.

机构信息

Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China.

出版信息

J Orthop Surg Res. 2024 Jan 6;19(1):39. doi: 10.1186/s13018-023-04452-7.

DOI:10.1186/s13018-023-04452-7
PMID:38183149
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10770938/
Abstract

PURPOSE

This study aimed to perform a systematic review and meta-analysis to compare the clinical outcomes of open surgery and arthroscopic release in gluteal muscle contracture (GMC).

METHODS

Two independent reviewers YM and WL conducted a systematic search of PubMed, Embase, Cochrane Library, and Web of Science to identify clinical trials that adhered to the PRISMA guidelines (Appendix A), spanning from inception to July 2023. Search items included (("gluteal" OR "gluteus") AND ("contracture" OR "fibrosis")). Research comparing open surgery or arthroscopic release was included. Clinical outcomes were compared using the risk ratio for dichotomous variables and the standardized mean difference for continuous variables. A P value < 0.05 was deemed statistically significant.

RESULTS

Four studies with 453 patients met the selection criteria and were included in this review. Compared with open surgery, in the case of similar postoperative functional satisfaction (1.21, 95% CI = 0.46-3.17, P = 0.70), the arthroscopic release achieved advantages in postoperative complications (3.5, 95% CI = 1.75-7.03, P = 0.0004), cosmetic satisfaction (0.07, 95% CI = 0.01-0.65, P = 0.02), length size (5.65, 95% CI = 4.11-7.19, P < 0.001), and hospitalization duration (1.57, 95% CI = 0.89 to 2.26, P < 0.001).

CONCLUSION

This research shows that both open surgery and arthroscopic release improve functional satisfaction. The arthroscopic release could result in fewer complications, better cosmetic satisfaction, shorter length size, and shorter hospitalization duration. Registration and protocol There is no registration and protocol for this meta-analysis.

摘要

目的

本研究旨在进行系统评价和荟萃分析,比较臀肌挛缩(GMC)开放手术和关节镜松解的临床疗效。

方法

两名独立的审查员 YM 和 WL 按照 PRISMA 指南(附录 A),对 PubMed、Embase、Cochrane 图书馆和 Web of Science 进行了系统搜索,以确定符合条件的临床试验,时间跨度为从成立到 2023 年 7 月。搜索项包括("臀肌"或"臀肌")和("挛缩"或"纤维化")。包括比较开放手术或关节镜松解的研究。使用二项变量的风险比和连续变量的标准化均数差来比较临床结果。P 值<0.05 被认为具有统计学意义。

结果

符合选择标准并纳入本综述的四项研究共纳入 453 例患者。与开放手术相比,在术后功能满意度相似的情况下(1.21,95%CI=0.46-3.17,P=0.70),关节镜松解在术后并发症(3.5,95%CI=1.75-7.03,P=0.0004)、美容满意度(0.07,95%CI=0.01-0.65,P=0.02)、长度大小(5.65,95%CI=4.11-7.19,P<0.001)和住院时间(1.57,95%CI=0.89 至 2.26,P<0.001)方面具有优势。

结论

本研究表明,开放手术和关节镜松解均能提高功能满意度。关节镜松解可减少并发症、提高美容满意度、缩短长度大小和住院时间。

注册和方案 本荟萃分析没有注册和方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f7c/10770938/d4a05bba889e/13018_2023_4452_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f7c/10770938/b3be896e520e/13018_2023_4452_Fig1_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f7c/10770938/b3be896e520e/13018_2023_4452_Fig1_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f7c/10770938/6bbfcc2b3e07/13018_2023_4452_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f7c/10770938/e8435e8ad1d6/13018_2023_4452_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f7c/10770938/661e10cccbdf/13018_2023_4452_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f7c/10770938/e8b10702ccde/13018_2023_4452_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f7c/10770938/9d55ac2a55d6/13018_2023_4452_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f7c/10770938/d4a05bba889e/13018_2023_4452_Fig9_HTML.jpg

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