微创人工全膝关节置换与传统技术临床疗效比较的Meta分析

Clinical outcomes after MIS-TKA as compared with traditional techniques.A meta-analysis of randomized controlled trials

[目的]系统评价微创人工全膝关节置换(MISTKA)与传统TKA技术临床疗效的差异。[方法]计算机检索MEDLINE、Cochrane、Embase、CNKI数字图书馆等数据库,并手工检索查找有关比较MISTKA与传统术式的临床试验研究。由两名评价员独立筛查试验、提取资料和评估方法学质量,采用Cochrane协作网提供的RevMan 5.0软件进行Meta分析。[结果]共纳入符合本研究设计标准的临床随机对照试验11篇,微创组509膝,传统组459膝。两组在并发症发生率、下肢力线、出血量、术后KSS评分和KSS功能评分方面未发现统计学差异。止血带时间微创组长于传统组。[结论]MISTKA创伤小,并发症、术后功能、下肢力线较传统TKA无显著差异,长期效果尚需更多研究。

[Objective]To compare the clinical outcomes between the MIS（minimally invasive surgical） and conventional total knee arthroplasty（TKA）. [Methods]Randomized controlled trials about the comparison of conventional and MIS total knee arthroplasties were searched in MEDLINE,Cochrane Library,EMbase,and CNKI.We also hand-searched some published and unpublished references.Study selection and assessment,data collection and analysis were undertaken by two reviewers independently.The Cochrane Collaboration＇s RevMan 5.0 was used for data analyses. [Results]After a comprehensive search,11 original randomized controlled trials（involving 968 knees） were included in this analysis.The MIS-TKA group consisted of 509 knees,and the conventional TKA group consisted of 459 knees.All trails were identified as meeting all the eligibility criteria.The meta-analysis did not find a significant difference in the total complications,blood loss,postoperative Knee Society objective scores and functional Knee Society scores.The tourniquet time was significantly shorter（P.05） in the conventional TKA group than in the MIS-TKA group. [Conclusion]There is no statistically significant difference in complication,alignment of the leg,postoperative KSS scores between MIS-TKA and conventional TKA.MIS-TKA present minor trauma,but long-term clinical outcomes require further investigation.