内侧胫骨平台倾斜角与前交叉韧带损伤相关性的Meta分析

Meta-analysis on the association between medial tibial plateau slope angle and anterior cruciate ligament injuries

背景:内侧胫骨平台倾斜角作为前交叉韧带损伤的一项解剖学相关危险因素,一直受到研究者的重视,但其相关性的存在与否,各项研究的结果不尽相同。目的:分析内侧胫骨平台倾斜角与前交叉韧带损伤的相关性,并探讨其是否存在性别特异性。方法:计算机检索cochrane图书馆、MEDLINE数据库、Elsevier数据库、中国生物医学文献数据库、万方数据库以及手工检索相关文献的参考文献。所有检索截止至2011-11-01。收集国内外公开发表的有关内侧胫骨平台倾斜角与前交叉韧带损伤相关性的病例对照研究和横断面研究文献,采用STATA 11.0统计软件进行统计分析。结果与结论:纳入Meta分析的文献共12篇,累计研究对象1823例,损伤组888例,对照组925例。纳入研究表明,损伤组与对照组内侧胫骨平台倾斜角的合并加权均值差为1.06,95%CI(0.36,1.76),P<0.05;亚组分析结果表明,男性病例中损伤组与对照组内侧胫骨平台倾斜角的合并加权均值差为0.84,95%CI(-0.03,1.70),P>0.05,女性病例中损伤组与对照组内侧胫骨平台倾斜角的合并加权均值差(WMD)为1.62,95%CI(0.72,2.52),P<0.05。提示增大的内侧胫骨平台倾斜角与前交叉韧带损伤在女性患者中存在相关性,但目前尚未发现这一结论在男性中也成立。

BACKGROUND：As an anatomy associated risk factors of the anterior cruciate ligament injury,medial tibial plateau slope angle has been attracted much more attention,but as for the correlation between the anterior cruciate ligament injury and medial tibial plateau slope angle presence or absence,the results of the studies are not the same.OBJECTIVE：To determine the association between medial tibial plateau slope angle and anterior cruciate ligament injuries,and to investigate gender differences between anterior cruciate ligaments injured subjects and gender-matched controls.METHODS：The Cochrane library,Medline database,Elsevier database,Chinese Biomedical database and Wanfang database were retrieved by computer and the hand research of relevant literatures was performed.The deadline of all the retrieves was 2011-11-01.We included case-control and sectional studies on the association between medial tibial plateau slope angle and anterior cruciate ligament injury.The STATA11.0 software package was used for data-analysis.RESULTS AND CONCLUSION：Twelve trails with 1 823 objects were included for Meta analysis（888 objects in injury group and 925 objects in control group）.For the whole objects in the injury group and control group,the pooled weighted mean difference for medial tibial plateau slope angle was 1.06,95% confidence interval（CI）（0.36,1.76）,and P 0.05.Subgroup analysis showed that,for the male objects,the pooled weighted mean difference for medial tibial plateau slope angle in the injury group and the control group was 0.84,95%CI：（-0.03,1.70） and P 0.05.For the female objects,the pooled weighted mean difference for medial tibial plateau slope angle was 1.62,95%CI（0.72,2.52） and P 0.05.The results of this Meta-analysis suggest that increased medial tibial plateau slope appears to contribute to anterior cruciate ligament injuries in females,but not in males.