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关节镜手术并不优于膝骨关节炎的保守治疗:随机对照试验的系统评价和荟萃分析。

Arthroscopic surgery is not superior to conservative treatment in knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trails.

机构信息

Department of Orthopedics Surgery, The Third People's Hospital of Chengdu, Chengdu, China.

Third People's hospital of Chengdu, Chengdu, 610000, Sichuan, China.

出版信息

BMC Musculoskelet Disord. 2024 Sep 5;25(1):712. doi: 10.1186/s12891-024-07813-3.

Abstract

BACKGROUND

Studies comparing the effectiveness of arthroscopic knee surgery and conservative treatment on knee osteoarthritis (OA) came up with inconsistent results. Systematic review on this topic still is still lacking. This systematic review and meta-analysis aimed to evaluate the effectiveness of arthroscopic knee surgery on knee OA, compared to conservative treatments.

MATERIALS AND METHODS

Literature searches were performed in PubMed, Embase, and Cochrane Library databases for randomized controlled trials (RCTs) published before on 1st July 2024. Studies comparing the effectiveness of arthroscopy and conservative treatments only on knee OA were included. Quality of included studies was evaluated by risk of bias 2 (ROB2). Long-term results in terms of pain relief, functional recovery and patients reported satisfaction were meta-analyzed to evaluate the therapeutic effectiveness.

RESULTS

Ten studies were included in this review, among which only 1 was considered as low risk of bias. Five studies were involved in meta-analyses and no difference was found in therapeutic effectiveness of arthroscopic surgery and conservative treatment on knee OA, in the evaluation of VAS (p = 0.63), WOMAC (p = 0.38), SF-36 (p = 0.74) and patient satisfaction (p = 0.07).

CONCLUSION

The evidence does not support the effectiveness of arthroscopic knee surgery compared to conservative treatments in knee OA.

摘要

背景

比较关节镜膝关节手术和保守治疗对膝骨关节炎(OA)疗效的研究结果不一致。关于这个主题的系统评价仍然缺乏。本系统评价和荟萃分析旨在评估关节镜膝关节手术与保守治疗相比对膝骨关节炎的疗效。

材料与方法

在 PubMed、Embase 和 Cochrane Library 数据库中进行文献检索,检索截至 2024 年 7 月 1 日发表的随机对照试验(RCT)。纳入仅比较关节镜和保守治疗对膝骨关节炎疗效的研究。采用偏倚风险 2(ROB2)评估纳入研究的质量。通过荟萃分析评估长期疼痛缓解、功能恢复和患者报告满意度等方面的疗效,以评估治疗效果。

结果

本研究共纳入 10 项研究,其中仅 1 项被认为是低偏倚风险。5 项研究进行了荟萃分析,在 VAS(p=0.63)、WOMAC(p=0.38)、SF-36(p=0.74)和患者满意度(p=0.07)方面,关节镜手术和保守治疗对膝骨关节炎的疗效无差异。

结论

证据不支持关节镜膝关节手术与保守治疗相比对膝骨关节炎更有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e602/11375851/d18382a2a502/12891_2024_7813_Fig1_HTML.jpg

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