[1]许田恩,张少博,郭来威,等.膝关节镜下单双束重建后交叉韧带术后临床疗效的Meta分析[J].第三军医大学学报,2016,38(04):422-430.
 Xu Tian&rsquo,en,Zhang Shaobo,et al.Arthroscopic single-bundle vs double-bundle posterior cruciate ligament reconstruction: a Meta analysis[J].J Third Mil Med Univ,2016,38(04):422-430.
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膝关节镜下单双束重建后交叉韧带术后临床疗效的Meta分析(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
38卷
期数:
2016年第04期
页码:
422-430
栏目:
公共卫生与预防医学
出版日期:
2016-02-29

文章信息/Info

Title:
Arthroscopic single-bundle vs double-bundle posterior cruciate ligament reconstruction: a Meta analysis
作者:
许田恩张少博郭来威姜金张波孟会强张成俊盛晓赟韵向东夏亚一
兰州大学第二医院骨科,甘肃省骨关节疾病研究重点实验室
Author(s):
Xu Tian’en Zhang Shaobo Guo Laiwei Jiang Jin Zhang Bo Meng Huiqiang Zhang Chengjun Sheng Xiaoyun Yun Xiangdong Xia Yayi

Department of Orthopaedics, Gansu Provincial Key Laboratory of Orthopedics of Second Hospital,Lanzhou University, Lanzhou, Gansu Province, 730000, China

关键词:
关节镜单束重建双束重建后交叉韧带Meta分析
Keywords:
arthroscope single-bundle reconstruction double-bundle reconstruction posterior cruciate ligament Meta analysis
分类号:
R181.23;R684;R686.5
文献标志码:
A
摘要:

目的      评价膝关节镜下单双束重建后交叉韧带(posterior cruciate ligament,PCL)的临床疗效。      方法      检索Pubmed、Embase、The Cochrane Library、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、中文科技期刊数据库(VIP),全面检索发表的有关膝关节镜下经胫骨骨道单束、双束重建PCL的随机对照试验(randomized controlled trials,RCT)与非随机对照试验(non-RCT)。由2名研究者独立评价并交叉核对纳入文献的方法学质量评价,采用RevMan5.3软件进行统计学分析。      结果      共纳入8篇文献,包括4篇RCT,4篇回顾性对照研究,共计323例PCL损伤患者。Meta分析结果显示:膝关节镜下单束和双束重建PCL在Lysholm评分{MD=-3.51,95%CI[-4.54,-2.48],P<0.01}、Tegner评分{MD=-0.52,95%CI[-0.89,-0.14],P=0.007}、IKDC正常与接近正常评分{OR=0.40,95%CI(0.19,0.84),P=0.01}、IKDC不正常与严重不正常评分{OR=2.48,95%CI(1.20,5.15),P=0.01}、膝关节屈曲90°时的后向稳定性评分{MD=0.92,95%CI(0.18,1.56),P=0.01}方面的Meta分析结果显示差异具有统计学意义;而2组在膝关节屈曲30°时的后向稳定性评分{MD=0.63,95%CI(-1.63,2.61),P=0.54}、术后并发症发生率{OR=0.60,95%CI(0.22,1.62),P=0.32}方面无统计学差异。      结论      关节镜下经胫骨骨道PCL的单束重建优于双束重建,且手术难度较小、损伤较小、骨道位置较易控制,但膝关节屈曲90°时的后向稳定性较双束重建差。

Abstract:

Objective      To evaluate the effectiveness of single-bundle vs double-bundle posterior cruciate ligament (PCL) reconstruction under arthroscope.       Methods      Randomized controlled trials (RCTs) and non-randomized controlled trials (non-RCTs) of arthroscopic single-bundle vs double-bundle PCL reconstructionpublished in PubMed, Embase, Cochrane library, China national knowledge infrastructure (CNKI),Chinese biomedical literature database (CBM),and VIP were searched. All the data were analyzed by 2 reviewers independently using RevMan5.3 software.       Results      The Meta analysis included 323 patients with PCL injure, and there were four RCTs and four non-RCTs. The results of Meta analysis showed that there were significant differences in Lysholm scores [MD=-3.51, 95%CI(-4.54,-2.48), P<0.000 01], Tegner scores [MD=-0.52, 95%CI(-0.89,-0.14), P=0.007], IKDC normal and nearly normal [OR=0.40, 95%CI (0.19,0.84), P=0.01], IKDC abnormal and severe abnormal [OR=2.48, 95%CI (1.20,5.15), P=0.01], and flexion 90°posterior stability [MD=0.92, 95%CI (0.18,1.56), P=0.01]between single-bundle PCL reconstructionand double-bundle PCL reconstruction. However, no statistical significance difference was found in flexion 30° posterior stability [MD=0.63, 95%CI (-1.63,2.61), P=0.54] and postoperative complication rate [OR=0.60, 95%CI (0.22,1.62), P=0.32].       Conclusion      The current clinical evidence shows that single-bundle PCL reconstruction is superior to double-bundle PCL reconstruction, with easy operation, less injure and easily controlled tunnel location, but the flexion 90° posterior stability is inferior to double-bundle PCL reconstruction.

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更新日期/Last Update: 2016-01-29