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成人患者中缝线锚钉与经骨隧道髌腱修复技术的生物力学评估及功能评分比较分析:一项系统评价与荟萃分析

Biomechanical Evaluation and Comparative Analysis of Functional Scores in Suture Anchor Versus Transosseous Tunnel Patellar Tendon Repair Techniques in Adult Patients: A Systematic Review and Meta-Analysis.

作者信息

Elnewishy Ahmed, Elsenosy Abdelfatah M, Teama Hagar, Salem Mohamed

机构信息

Orthopaedics, Royal Berkshire Hospital NHS, Reading, GBR.

Orthopaedic Surgery, Elkasr Elainy Medical School, Kafr Elsheikh, EGY.

出版信息

Cureus. 2024 Nov 11;16(11):e73495. doi: 10.7759/cureus.73495. eCollection 2024 Nov.

Abstract

Patellar tendon injuries, although less frequent than other knee injuries, can have a profound impact on knee function, often leading to significant disability. Among the various surgical techniques employed to repair these injuries, the suture anchor and transosseous tunnel methods are the most commonly used. This systematic review and meta-analysis compares the biomechanical properties and functional outcomes of these two repair techniques. A thorough search of relevant databases was conducted until June 2024, including studies that directly compared the suture anchor and transosseous tunnel methods for patellar tendon repair. Data extraction and quality assessments were performed independently by two reviewers. The primary outcomes assessed were biomechanical strength and functional recovery, using the International Knee Documentation Committee (IKDC) scores, Lysholm score, and Kujala score. A total of four studies involving 196 participants met the inclusion criteria. Both techniques were found to significantly improve functional outcomes. However, suture anchor repairs were associated with lower complication rates and earlier rehabilitation compared to the transosseous tunnel technique. Despite these differences, the meta-analysis showed no statistically significant difference in postoperative IKDC scores between the two methods. In conclusion, while both the suture anchor and transosseous tunnel techniques are effective for patellar tendon repair, the suture anchor method appears to offer biomechanical advantages, fewer complications, and faster recovery. Further high-quality research is recommended to validate these findings.

摘要

髌腱损伤虽然比其他膝关节损伤少见,但会对膝关节功能产生深远影响,常导致严重残疾。在用于修复这些损伤的各种手术技术中,缝线锚钉法和经骨隧道法是最常用的。本系统评价和荟萃分析比较了这两种修复技术的生物力学特性和功能结局。截至2024年6月,对相关数据库进行了全面检索,包括直接比较缝线锚钉法和经骨隧道法修复髌腱的研究。由两名评价者独立进行数据提取和质量评估。评估的主要结局是生物力学强度和功能恢复情况,采用国际膝关节文献委员会(IKDC)评分、Lysholm评分和Kujala评分。共有四项涉及196名参与者的研究符合纳入标准。发现两种技术均能显著改善功能结局。然而,与经骨隧道技术相比,缝线锚钉修复的并发症发生率更低,康复时间更早。尽管存在这些差异,但荟萃分析显示两种方法术后IKDC评分在统计学上无显著差异。总之,虽然缝线锚钉法和经骨隧道技术对髌腱修复均有效,但缝线锚钉法似乎具有生物力学优势、并发症更少且恢复更快。建议进行进一步的高质量研究以验证这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71a6/11638015/c3642bc7febf/cureus-0016-00000073495-i01.jpg

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