单髁置换术治疗膝骨关节炎对术后人工关节遗忘程度影响的Meta分析

Efficacy of unicompartmental knee arthroplasty on forgotten joint score in patients with knee osteoarthritis:a meta-analysis

目的系统评价单髁置换术治疗膝骨关节炎对术后人工关节遗忘程度的影响。方法计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、CNKI、CBM、WanFang Data和VIP数据库,搜集单髁置换术治疗膝骨关节炎对术后人工关节遗忘程度影响的随机对照试验(RCT)和队列研究,检索时限均从建库至2019年12月31日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入2个RCT和11个队列研究。针对RCT的Meta分析结果显示,单髁置换术术后12个月的人工关节遗忘评分(FJS)高于后交叉韧带稳定型全膝关节置换术[MD=9.23,95%CI(0.53,17.93),P=0.04]。针对队列研究的Meta分析结果显示,单髁置换术术后6周[MD=8.90,95%CI(6.87,10.94),P<0.00001]、6个月[MD=18.72,95%CI(8.71,28.74),P=0.0002]、1年[MD=13.41,95%CI(8.87,17.95),P<0.00001]和末次随访时[MD=0.99,95%CI(0.47,1.54),P=0.0002]的FJS均高于后交叉韧带稳定型全膝关节置换术。结论现有证据显示单髁置换术治疗膝骨关节炎,在术后FJS方面优于后交叉韧带稳定型全膝关节置换术。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。

Objectives To systematically review the efficacy of unicompartmental knee arthroplasty on forgotten joint score(FJS)in patients with knee osteoarthritis.Methods PubMed,EMbase,The Cochrane Library,Web of Science,CNKI,CBM,WanFang Data and VIP databases were electronically searched to collect randomized controlled trials(RCTs)and cohort studies on unicompartmental knee arthroplasty on FJS in patients with knee osteoarthritis from inception to December 31st,2019.Two reviewers independently screened literature,extracted data and assessed risk of bias of included studies,then,meta-analysis was performed by using RevMan 5.3 software.Results A total of 2 RCTs and 11 cohort studies were included.The results of meta-analysis based on RCTs showed that:compared to posterior stabilized total knee arthroplasty(PS-TKA),unicompartmental knee arthroplasty could improve FJS on 12-month(MD=9.23,95%CI 0.53 to 17.93,P=0.04)after operation.The results of meta-analysis based on cohort studies showed that:compared to PS-TKA,unicompartmental knee arthroplasty could improve FJS on 6-week(MD=8.90,95%CI 6.87 to 10.94,P<0.00001),6-month(MD=18.72,95%CI 8.71 to 28.74,P=0.0002),1-year after operation(MD=13.41,95%CI 8.87 to 17.95,P<O.OOO 01),and the last follow-up(MD=0.99,95%CI 0.47 to 1.54,P=0.0002).Conclusions Current evidence shows that,comparing with PS-TKA,unicompartmental knee arthroplasty in knee osteoarthritis shows advantage in the improvement of FJS.Due to limited quality and quantity of the included studies,more high-quality studies are required to verify above conclusions.