股骨髁间凹尺寸与前交叉韧带损伤关系的Meta分析

Meta-analysis on the relationship between femoral intercondylar notch size and anterior cruciate ligament injury

背景:既往一些研究均有探讨股骨髁间凹参数与前交叉韧带损伤的相关性,但尚无统一结论,且从未有学者对这一问题进行过Meta分析。目的:分析股骨髁间凹尺寸与前交叉韧带损伤的相关性,为前交叉韧带损伤的病因研究和有效的预防控制措施提供科学依据。方法:检索MEDLINE、AMED、EMBASE和Cochrane Library等英文数据库以及中国生物医学文献数据库等中文数据库,收集国内外公开发表的有关股骨髁间凹尺寸与前交叉韧带损伤相关性的病例对照研究和前瞻性队列研究文献,采用RevMan5.0和STATA11.0统计软件进行统计分析。结果与结论:纳入Meta分析的文献共20篇,其中病例对照研究16篇,前瞻性队列研究4篇,累计研究对象4532例,损伤组1316例,对照组3216例。纳入研究表明,损伤组与对照组的股骨髁间凹指数的合并加权均值差(WMD)为-0.04,95%CI:(-0.05,-0.02),P<0.05;损伤组与对照组的股骨髁间凹宽度的合并加权均值差(WMD)为-1.47,95%CI:(-1.92,-1.02),P<0.05。结果可见减小的股骨髁间凹尺寸与前交叉韧带损伤存在相关性,但仍需开展更多高质量、大样本的研究来证实这一结论。

METHODS： The Medline database, AMED database, Embase database, Cochrane Library and Chinese Biomedical database were searched, and the case-control studies and prospective cohort studies on the relationship between femoral intercondylar notch size and anterior cruciate ligament injury were collected. The Revman5.0 and STATA11.0 software package were used for data analysis. RESULTS AND CONCLUSION： Twenty meta-analysis literatures were involved, including 16 case-control studies and 4 prospective cohort studies. A total of 4 532 subjects were included （1 316 subjects in the injury group and 3 216 in the control group）. The pooled weighted mean difference for femoral intercondylar notch index between the injury group and the control group was [-0.04, 95% confidence interval：（-0.05, -0.02）, P 〈 0.05]. The pooled weighted mean difference for femoral intercondylar notch width between the injury group and the control group was [-1.47, 95% confidence interval： （-1.92, -1.02）, P 〈 0.05]. The results of this meta-analysis suggest that there is correlation between femoral intercondylar notch size and anterior cruciate ligament injury, but more high-quality and large sample studies are needed to confirm this conclusion. Key Words： bone and joint implants; evidence based medicine of bone and joint; anterior cruciate ligament; injury; Meta-analysis; femur; intercondytar notch index; intercondylar notch width; intercondylar notch parameter; risk factor： correlation