单束和双束后交叉韧带重建术的对比:系统综述及meta分析

Single-bundle versus double-bundle in posterior cruciate ligament reconstruction: a systematic review and meta-analysis

目的研究单束和双束后交叉韧带重建术疗效之间的差异。方法利用网络对Pub Med,EMBASE,Cochrane Central Register of Controlled Trails,维普和万方数据库进行搜索,纳入对比单束和双束后交叉韧带重建术疗效的临床研究。研究的质量利用Cochrane偏倚风险评价表进行评价。利用Rev Man 5.2软件对研究数据进行meta分析,计算比值比(OR)和均差(MD),同时进行I2检验评价meta分析的异质性。结果 Meta分析结果显示,双束后交叉韧带重建术的IKDC(P=0.04),Tegner(P=0.02)和Lysholm(P=0.02)评分明显高于单束重建术。双束重建术的胫骨前后移动度与单束重建术比较存在异质性。结论双束后交叉韧带重建术在恢复膝关节运动功能的疗效上优于单束重建术,而双束重建术能否全面取代单束重建术仍然有待更深入长远的临床研究来证明。

Objective To investigate the difference of single-bundle （SB） versus double-bundle （DB） posterior cruciate ligament（PCL） reconstruction. Methods An online search of databases PubMed, EMBASE and Cochrane Central Register of Controlled Trails, Weipu and Wanfang was performed. The clinical studies comparing the outcomes of single-bundle versus double-bundle PCL reconstruction were included. Cochrane Collaboration＇s risk-of-bias tool was used to assess the quality of studies. Meta-analysis by calculating the odd radio （OR） and mean difference （MD） was performed using RevMan 5.2 software. I2 test was used to assess the heterogeneity. Results The results of meta-analysis showed that double-bundle PCL reconstruction had higher IKDC （P=0.04）, Tegner （P=0.02） and Lysholm （P=0.02） scores than single-bundle reconstruction. Conclusion The DB reconstruction showed better results in restoring the knee function than SB reconstruction. Further clinical studies are still necessary to reveal whether DB reconstruction could replace of SB reconstruction.