膝关节单髁骨关节炎中外侧与内侧单髁置换临床疗效的比较：一项荟萃分析。
Comparison of the clinical efficacy of lateral versus medial unicondylar replacement for unicompartmental osteoarthritis of the knee: a meta-analysis.
作者信息
Bai Haowei, Liu Pengyu, Li Hao, Yang Jiaju, Li Zhitong, Guo Qidong, Zhang Min
机构信息
Department of Orthopaedic Surgery, Shanxi Medical University Second Affiliated Hospital, Taiyuan, China.
Department of Orthopaedic Surgery, Tianjin Medical University General Hospital, Tianjin, China.
出版信息
J Orthop Surg Res. 2025 Jan 4;20(1):12. doi: 10.1186/s13018-024-05404-5.
OBJECTIVE
This meta-analysis evaluates the comparative efficacy of lateral unicompartmental arthroplasty (UKA) versus medial UKA in treating unicompartmental knee osteoarthritis (KOA).
METHODS
We systematically searched Cochrane, PubMed, Embase, and Web of Science databases from January 2000 to September 2024. Literature screening, quality assessment, and data extraction were conducted based on predefined inclusion and exclusion criteria. Review Manager 5.4 software was used to analyze postoperative functional scores, pain scores, aseptic loosening, progression of contralateral arthritis, and prosthesis survival.
RESULTS
Fifteen cohort studies, encompassing 2,592 knees with medial UKA and 614 knees with lateral UKA, were included. The analysis showed no statistically significant differences in functional scores [SMD = 0.11, 95% CI (- 0.10, 0.33), I = 64%, P = 0.31], pain scores [SMD = 0.23, 95% CI: (- 0.22, 0.67), I = 91%, P = 0.32], aseptic loosening [OR = 1.33, 95% CI: (0.31, 5.78), I = 0%, P = 0.70], progression of contralateral arthritis [OR = 0.37, 95% CI: (0.07, 1.91), I = 0%, P = 0.23], short- to intermediate-term survival [OR = 1.40, 95% CI: (0.84, 2.35), I = 0%, P = 0.20], and long-term survival [OR = 1.12, 95% CI: (0.61, 2.05), I = 0%, P = 0.70].
CONCLUSION
Our findings indicate no significant differences in functional outcomes, pain relief, aseptic loosening, progression of contralateral arthritis, or prosthesis survival between lateral and medial UKA. Thus, both approaches are reliable options for patients with unicompartmental KOA.
目的
本荟萃分析评估外侧单髁关节置换术（UKA）与内侧UKA治疗单髁膝关节骨关节炎（KOA）的相对疗效。
方法
我们系统检索了2000年1月至2024年9月的Cochrane、PubMed、Embase和Web of Science数据库。根据预先设定的纳入和排除标准进行文献筛选、质量评估和数据提取。使用Review Manager 5.4软件分析术后功能评分、疼痛评分、无菌性松动、对侧关节炎进展和假体生存率。
结果
纳入了15项队列研究，包括2592例接受内侧UKA的膝关节和614例接受外侧UKA的膝关节。分析显示，在功能评分[标准化均数差（SMD）=0.11，95%可信区间（CI）（-0.10，0.33），I²=64%，P=0.31]、疼痛评分[SMD=0.23，95%CI：（-0.22，0.67），I²=91%，P=0.32]、无菌性松动[比值比（OR）=1.33，95%CI：（0.31，5.78），I²=0%，P=0.70]、对侧关节炎进展[OR=0.37，95%CI：（0.07，1.91），I²=0%，P=0.23]、短期至中期生存率[OR=1.40，95%CI：（0.84，2.35），I²=0%，P=0.20]和长期生存率[OR=1.12，95%CI：（0.61，2.05），I²=0%，P=0.70]方面，均无统计学显著差异。
结论
我们的数据表明，外侧和内侧UKA在功能结局、疼痛缓解、无菌性松动、对侧关节炎进展或假体生存率方面无显著差异。因此，对于单髁KOA患者，这两种方法都是可靠的选择。
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