Guo Hua, Huang Ling-An, Li Hao-Qian, Guo Li, Li Peng-Cui, Wei Xiao-Chun
Department of Orthopaedics, second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China; Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan 030001, Shanxi, China.
Department of Orthopaedics, second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China; Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan 030001, Shanxi, China; Department of Pain Medicine, Sanya Central Hospital of Hainan Medical College, Sanya 572000, Hainan, China.
Zhongguo Gu Shang. 2024 Mar 25;37(3):300-5. doi: 10.12200/j.issn.1003-0034.20220937.
To explore clinical efficacy of autologous bone grafts and bone substitute for the treatment of tibial plateau fractures by Meta analysis.
Controlled clinical studies on autogenous bone transplantation and bone substitutes in treating tibial plateau fractures published on PubMed,Web of Science,CNKI,Wanfang and other databases from January 2005 to August 2022 were searched by computer. Literature screening and data extraction were performed according to randomized controlled trial(RCT),and the quality of RCT were evaluated by using intervention meta-analysis criteria in Cochrane manual. Meta-analysis of joint depression,secondary collapse rate of articular surface,blood loss,operative time and infection rate between two methods were performed by Rev Man 5.3 software.
Seven RCT studies (424 patients) were included,296 patients in bone replacement group and 128 patients in autograft group. Operative time [=-16.79,95%(-25.72,-7.85),=0.000 2] and blood loss[=-70.49,95%(-79.34,-61.65),<0.000 01] between two groups had statistically differences,while joint depression[=-0.17,95%(-0.91,0.58),=0.66],secondary collapse rate of joint surface[=-0.74, 95%(0.35,1.57),=0.43],infection rate [=1.21,95%(0.31,4.70),=0.78] between two groups had no differences.
The effects of bone substitute and autograft for the treatment of tibial plateau fracture have similar effects in terms of joint depression,secondary articular surface collapse rate and infection rate. However,compared with autologous bone transplantation,bone replacement could reduce blood loss and shorten operation time.
通过Meta分析探讨自体骨移植和骨替代物治疗胫骨平台骨折的临床疗效。
通过计算机检索2005年1月至2022年8月在PubMed、Web of Science、CNKI、万方等数据库发表的关于自体骨移植和骨替代物治疗胫骨平台骨折的对照临床研究。按照随机对照试验（RCT）进行文献筛选和数据提取，并采用Cochrane手册中的干预性Meta分析标准对RCT质量进行评价。使用Rev Man 5.3软件对两种方法之间的关节塌陷、关节面二次塌陷率、失血量、手术时间和感染率进行Meta分析。
纳入7项RCT研究（424例患者），骨替代组296例，自体骨移植组128例。两组间手术时间[=-16.79，95%（-25.72，-7.85），=0.000 2]和失血量[=-70.49，95%（-79.34，-61.65），<0.000 01]有统计学差异，而两组间关节塌陷[=-0.17，95%（-0.91，0.58），=0.66]、关节面二次塌陷率[=-0.74，95%（0.35，1.57），=0.43]、感染率[=1.21，95%（0.31，4.70），=0.78]无差异。
骨替代物和自体骨移植在治疗胫骨平台骨折方面，在关节塌陷、关节面二次塌陷率和感染率方面效果相似。然而，与自体骨移植相比，骨替代物可减少失血量并缩短手术时间。
