单半径和多半径后稳定型膝关节假体疗效的Meta分析

Meta-analysis on outcome of single-versus multi-radius posterior stabilized prostheses in total knee arthroplasty

目的比较单半径(SR)和多半径(MR)后稳定型假体在全膝关节置换(TKA)术后的临床疗效。方法对荷兰医学文摘(Embase),Web of Science和Cochrane临床对照试验中心注册库4个数据库进行检索,选择使用单半径(SR)和多半径(MR)后稳定型假体作为初次膝关节置换的随机对照研究提取相关资料。采用RevMan 5.3软件对纳入数据进行异质性检验和Meta分析。结果最终纳入7篇随机对照试验文献(RCTs),共667位患者、667例膝关节置换。结果显示:SR与MR假体术后随访的膝关节评分系统的功能评分、膝关节牛津评分、活动度、屈曲度、站立位最小屈曲度、并发症等结果的差异无统计学意义(P>0.05)。而SR全膝关节置换术术后膝关节评分系统的膝关节评分和站立位最大屈曲度优于MR假体,差异具有统计学意义(I2=1%,Z=2.03,P<0.05)。结论SR和MR后稳定型假体在膝关节置换中的术后临床效果无明显差异,但SR假体的术后膝关节评分系统的膝关节评分和站立位最大屈曲度要优于MR。

Objective To compare single radius(SR)and multi radius(MR)femoral posterior stabilized prostheses in total knee arthroplasty(TKA).Methods The articles about TKA treated by SR and MR were searched in PubMed,Web of Science,the Cochrane Central Register of Controlled Trials(the Cochrane Central Register)and Excerpta Medica Database(Embase).The databases from a randomized controlled trials using SR and MR femoral posterior stabilized prostheses in firstly TKA were selected.The meta-analysis and heterogeneity test were performed with RevMan 5.3 software.Results Seven randomized controlled trials(RCTs)reporting 667 patients underwent total knee replacements were included in current study.The outcomes of this meta-analysis indicated that there were no significant statistical difference in Knee Society scores of functions,the range of motion,the flexion,the min flexion in stance phase and the complications between SR and MR TKA(P>0.05).The Knee Society scores of knee and max flexion in stance phase of SR were better than MR(I2=1%,Z=2.03,P<0.05).Conclusion No significant clinical difference is found between SR and MR posterior stabilized prostheses in TKA,but the Knee Society scores of knee and the max flexion in stance phase of SR are better than MR.