多孔钽金属加强块重建PaproskyⅡ、Ⅲ型髋臼骨缺损并发症的荟萃分析

A meta-analysis on the complications of porous tantalum metal blocks for reconstructing Paprosky typeⅡ-Ⅲ acetabular bone defects

[目的]利用荟萃分析单个率的方法,对以英文方式发表的相关文献进行分析,总结多孔钽金属加强块重建Ⅱ、Ⅲ型Paprosky髋臼骨缺损并发症的种类及其发生率。[方法]采用询证医学的研究方法,以"acetabular defects"或"Paprosky"或"tantalum metal"词,检索Cochrane Database、Pubmed Medline、Ovid Medline、Embase Database等数据库,检索截止至2018年2月所有以英文发表的文献,共检索到281篇文献。根据检索条件和评价标准,最终筛选出17篇文献,共计641例。采用R软件的Meta程序包对检索结果进行统计分析。[结果]多孔钽金属加强块重建Ⅱ、Ⅲ型Paprosky髋臼骨缺损主要的并发症发生率如下:术区感染(3.59%, 95%CI 0.03～0.07)、假体无菌性松动(1.72%,95%CI 0.02～0.06))、髋关节脱位(3.74%,95%CI 0.03～0.07)和血管神经损伤(1.09%,95%CI 0.01～0.07)。[结论]多孔钽金属加强块重建Ⅱ、Ⅲ型Paprosky髋臼骨缺损主要的并发症发生率较低,术区感染、假体无菌性松动、髋关节脱位和血管神经损伤是较常见的并发症,术者在围手术期应该多加防范。

[Objective] To summarize the types and the incidence of complications of porous tantalum metal reinforcing blocks for reconstructing Paprosky type Ⅱ and Ⅲ acetabular bone defects on the literature published in English using the method of meta-analysis of single rate. [Methods] The databases, such as Cochrane Database, Pubmed Medline, Ovid Medline, and Embase Database, were retrieved with the words of "acetabular defects" or "paprosky" or "tantalum metal" from the beginning to February 2018. A total of 281 documents were searched in the English-published literature. Based on the including criteria,17 articles enrolled into this study eventually, involving 641 patients, were statistically analyzed with the Meta package of R software. [Results] The main complications of porous tantalum metal reinforcements for reconstructing Paprosky type Ⅱ and Ⅲ acetabular bone defects proved the surgical site infection with incidence of(3.59%, 95% CI: 0.03~0.07), aseptic loosening of the prosthesis(1.72%, 95% CI: 0.02~0.06), hip dislocation(3.74%, 95% CI: 0.03~0.07) and neurovascular injuries( 1.09%, 95%CI: 0.01~0.07). [Conclusion] The porous tantalum metal reinforcing blocks for reconstructing Paprosky type Ⅱ and Ⅲ acetabular bone defects has relatively less complications, including wound infection, aseptic loosening of prosthesis, hip dislocation and neurovascular injuries, which should be paid attention to prevent.