单髁置换术和全膝置换术在膝关节骨性关节炎中的应用效果Meta分析

Meta-analysis of application effects of unicondylar knee arthroplasty and total knee arthroplasty in knee osteoarthritis

[目的]分析单髁置换术(UKA)和全膝置换术(TKA)在膝关节骨性关节炎中的应用效果.[方法]以单髁置换、UKA、全膝置换、TKA为关键词,检索PubMed,EMBASE,Cochrane图书馆、中国知网、万方和维普数据库中关于UKA和TKA在膝关节骨性关节炎中应用的国内外随机对照研究文献,筛选出符合评价标准的文献,采用Revman 5.2软件进行Meta分析.[结果] UKA组术后HSS评分明显优于TKA组[WMD=3.84,95%CI(3.34,4.35),P<0.01],而两组在术后并发症方面差异无统计学意义[OR=0.70, 95%CI(0.42,1.16),P=0.16];UKA组术中出血量及术后引流量均明显少于TKA组,手术时间明显短于TKA组,术后血红蛋白下降值明显低于TKA组,差异均有统计学意义(P<0.01).[结论] UKA组手术时间和术后功能评分优于TKA组,出血量少于TKA组,在严格掌握适应症的基础上建议优先选择UKA治疗膝关节骨性关节炎.

OBJECTIVE To analyze the application effects of unicondylar knee arthroplasty(UKA) and total knee arthroplasty(TKA) in knee osteoarthritis. METHODS Domestic and overseas literatures of randomized controlled studies about the application of UKA and TKA in knee osteoarthritis were searched from PubMed,EMBASE,Cochrane Library, China Knowledge Network Database, Wanfang Database and Weipu Database with the keywords of unicondylar knee arthroplasty, UKA, total knee arthroplasty and TKA, screening out the literatures that met the evaluation criteria, and Meta analysis was performed using Revman 5.2 software. RESULTS Postoperative HSS score of UKA group was significantly better than that of TKA group [WMD=3.84, 95% CI(3.34, 4.35), P<0.01], however there was no significant difference in postoperative complications between the two groups [OR=0.70, 95% CI(0.42, 1.16),P=0.16]. The amount of intraoperative blood loss and postoperative drainage volume in the UKA group were significantly less than those in the TKA group, the operation time was significantly shorter than that in the TKA group, and the postoperative hemoglobin decline value was significantly lower than that in the TKA group, the differences were statistical significance(P<0.01). CONCLUSION The UKA group had better operation time and postoperative functional score than the TKA group, and less bleeding. On the basis of strictly mastering the indications, it was suggested to give priority to the UKA for the treatment of knee osteoarthritis.