膝关节骨关节炎患者单髁置换与全膝关节置换的长期疗效比较：一项系统评价与荟萃分析

Comparative long-term outcomes of unicompartmental and total knee arthroplasty in knee osteoarthritis patients: a systematic review and meta-analysis.

作者信息

Hu Hai, Li Pengfei, Liu Zelin, Lv Hang, Yang Xiangjun, Liu Peiran

机构信息

Department of Bone Injuries, Hanan Branch of the Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin, China.

Department of Medical Services Division, The Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin, China.

出版信息

Front Surg. 2024 Aug 21;11:1405025. doi: 10.3389/fsurg.2024.1405025. eCollection 2024.

DOI:10.3389/fsurg.2024.1405025

PMID:39233767

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11371575/

Abstract

BACKGROUND

Long-term outcomes for knee osteoarthritis patients undergoing unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) remain inconclusive.

OBJECTIVES

This study aims to evaluate the long-term outcomes over five years, including Knee Society Pain Scores (KSPS), Knee Society Scores (KSS), Knee Society Function Scores (KSFS), range of motion (ROM), and survival rates-of UKA vs. TKA in knee osteoarthritis patients.

DESIGN

Systematic review using data from randomized controlled and cohort trials, and world databases.

DATA SOURCES

Researchers searched Medline, Embase, Cochrane Controlled Register of Trials, and ClinicalTrials.gov from January 1990 to March 2024.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

The researchers selected studies based on adult participants with knee osteoarthritis. Eligible studies compare UKA and TKA reports on clinical or surgical outcomes, including KSPS, KSS, KSFS, ROM and survival rates, over 5 years. The researchers excluded the studies fewer than five years, or if English text was unavailable.

RESULTS

Researchers categorized twenty-nine eligible studies into three groups: five randomized controlled trials, 11 registries and database studies, and 13 cohort studies. The analysis revealed that neither TKA nor UKA definitively outperformed the other in terms of pain (SMD (95% CI): -0.06 [-0.41, 0.28], = 90%) and KSS scores (SMD (95% CI): -0.07 [-0.23, 0.008], = 81%) over a period of five years. However, KSFS (SMD (95% CI): -0.30 [-0.43, -0.17], = 74%) and ROM (SMD (95% CI): -0.78 [-1.11, -0.46], = 92%) tended to favor UKA, and survival rate favor TKA at 5 or over 5-year follow-up periods.

CONCLUSIONS

UKA shows a trend towards better outcomes in KSFS and ROM, alongside a more favorable survival rate in TKA at the five-year and beyond follow-up periods.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=517835, PROSPERO (CRD42024517835).

摘要

背景

接受单髁膝关节置换术（UKA）和全膝关节置换术（TKA）的膝关节骨关节炎患者的长期预后尚无定论。

目的

本研究旨在评估膝关节骨关节炎患者UKA与TKA在五年以上的长期预后，包括膝关节协会疼痛评分（KSPS）、膝关节协会评分（KSS）、膝关节协会功能评分（KSFS）、活动范围（ROM）和生存率。

设计

使用来自随机对照试验、队列研究和全球数据库的数据进行系统评价。

数据来源

研究人员检索了1990年1月至2024年3月的Medline、Embase、Cochrane对照试验注册库和ClinicalTrials.gov。

选择研究的纳入标准

研究人员根据成年膝关节骨关节炎参与者选择研究。符合条件的研究比较UKA和TKA关于临床或手术结局的报告，包括五年以上的KSPS、KSS、KSFS、ROM和生存率。研究人员排除了少于五年的研究，或没有英文文本的研究。

结果

研究人员将29项符合条件的研究分为三组：5项随机对照试验、11项注册库和数据库研究以及13项队列研究。分析显示，在五年期间，TKA和UKA在疼痛（标准化均数差（95%CI）：-0.06[-0.41,0.28]，P = 90%）和KSS评分（标准化均数差（95%CI）：-0.07[-0.23,0.008]，P = 81%）方面均未明显优于对方。然而，在5年及以上的随访期内，KSFS（标准化均数差（95%CI）：-0.30[-0.43,-0.17]，P = 74%）和ROM（标准化均数差（95%CI）：-0.78[-1.11,-0.46]，P = 92%）倾向于UKA，而生存率倾向于TKA。