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[1]吳高藝,林曉東,宋敏,等.脛骨結(jié)節(jié)上與脛骨結(jié)節(jié)下內(nèi)側(cè)開放楔形脛骨高位截骨術(shù)治療內(nèi)側(cè)間室膝骨關(guān)節(jié)炎有效性和安全性的Meta分析[J].中醫(yī)正骨,2022,34(02):44-50.
　WU Gaoyi,LIN Xiaodong,SONG Min,et al.Clinical outcome and safety of medial open-wedge high tibial osteotomy above and below the tibial tuberosity for treatment of medial compartment knee osteoarthritis:a meta-analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(02):44-50.
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脛骨結(jié)節(jié)上與脛骨結(jié)節(jié)下內(nèi)側(cè)開放楔形脛骨高位截骨術(shù)治療內(nèi)側(cè)間室膝骨關(guān)節(jié)炎有效性和安全性的Meta分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期數(shù):
2022年02期
頁(yè)碼:
44-50
欄目:
文獻(xiàn)研究
出版日期:
2022-02-20

文章信息/Info

Title:
Clinical outcome and safety of medial open-wedge high tibial osteotomy above and below the tibial tuberosity for treatment of medial compartment knee osteoarthritis:a meta-analysis
作者:
吳高藝; 林曉東; 宋敏; 李聰聰; 李安安; 林文政; 蔡宇寧; 劉文剛
廣州中醫(yī)藥大學(xué)第五臨床醫(yī)學(xué)院,廣東 廣州 510095
Author(s):
WU Gaoyi; LIN Xiaodong; SONG Min; LI Congcong; LI An'an; LIN Wenzheng; CAI Yuning; LIU Wengang
The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510095,Guangdong,China
關(guān)鍵詞:
骨關(guān)節(jié)炎; 膝;  截骨術(shù);  脛骨結(jié)節(jié);  專題Meta分析;  系統(tǒng)評(píng)價(jià)
Keywords:
osteoarthritis; knee;  osteotomy;  tibial tubercle;  meta-analysis as topic;  systematic review
摘要:
目的:系統(tǒng)評(píng)價(jià)脛骨結(jié)節(jié)上與脛骨結(jié)節(jié)下內(nèi)側(cè)開放楔形脛骨高位截骨術(shù)(open-wedge high tibial osteotomy,OWHTO)治療內(nèi)側(cè)間室膝骨關(guān)節(jié)炎(knee osteoarthritis,KOA)的有效性和安全性。方法:通過計(jì)算機(jī)檢索PubMed、Cochrane Library、Embase、中國(guó)知網(wǎng)、萬(wàn)方數(shù)據(jù)庫(kù)、維普網(wǎng)2000年1月1日至2020年12月31日收錄的比較脛骨結(jié)節(jié)上(試驗(yàn)組)與脛骨結(jié)節(jié)下(對(duì)照組)內(nèi)側(cè)OWHTO治療內(nèi)側(cè)間室KOA的有效性和安全性的隨機(jī)對(duì)照臨床研究和回顧性臨床研究文獻(xiàn)。由2名研究者獨(dú)立按照統(tǒng)一的評(píng)價(jià)指標(biāo)及文獻(xiàn)信息提取表進(jìn)行文獻(xiàn)篩選和數(shù)據(jù)提取,采用紐卡斯?fàn)?渥太華量表對(duì)納入的文獻(xiàn)進(jìn)行質(zhì)量評(píng)價(jià),采用Cochrane協(xié)作網(wǎng)提供的RevMan5.2軟件進(jìn)行Meta分析。結(jié)果:共檢索到257篇文獻(xiàn),經(jīng)過逐層篩選,最終納入12篇文獻(xiàn),共涉及752例內(nèi)側(cè)間室KOA患者,其中試驗(yàn)組416例、對(duì)照組336例。Meta分析結(jié)果顯示,試驗(yàn)組術(shù)后髕骨高度(Caton-Deschamps法、Blackburne-Peel法和Insall-Salvati法)、并發(fā)癥發(fā)生率均小于對(duì)照組[I2=0%,P=0.610,MD=-0.05,95%CI(-0.07,-0.02),P=0.001; I2=22%,P=0.280,MD=-0.06,95%CI(-0.10,-0.03),P=0.003; I2=88%,P=0.000,MD=-0.08,95%CI(-0.11,-0.05),P=0.000; I2=0%,P=0.960,MD=0.24,95%CI(0.07,0.83),P=0.020]; 試驗(yàn)組術(shù)后美國(guó)特種外科醫(yī)院膝關(guān)節(jié)功能評(píng)分、脛骨后傾角與對(duì)照組比較,差異無統(tǒng)計(jì)學(xué)意義[I2=73%,P=0.030,MD=1.01,95%CI(-1.24,3.25),P=0.380; I2=0%,P=0.600,MD=0.16,95%CI(-0.22,0.54),P=0.420]。結(jié)論:脛骨結(jié)節(jié)上與脛骨結(jié)節(jié)下內(nèi)側(cè)OWHTO治療內(nèi)側(cè)間室KOA的療效相當(dāng); 前者較后者更易導(dǎo)致術(shù)后低位髕骨,但其安全性高于后者。
Abstract:
Objective:To systematically review the clinical outcome and safety of medial open-wedge high tibial osteotomy(MOWHTO)above versus below the tibial tuberosity for treatment of medial compartment knee osteoarthritis(KOA).Methods:All the randomized controlled trial(RCT)articles and retrospective clinical trial articles about the clinical efficacy and safety of MOWHTO above the tibial tuberosity(experimental group)versus MOWHTO below the tibial tuberosity(control group)for treatment of medial compartment KOA included from January 1,2000 to December 31,2020 were retrieved from the PubMed,Cochrane Library,Embase,China National Knowledge Internet,Wanfang Database and Vip Database through computer.The articles were screened and the information was extracted independently by two researchers according to unified evaluation index and literature information extraction table.The methodological quality of research in the articles was evaluated according to the Newcastle-Ottawa scale(NOS)and a Meta-analysis was conducted by using RevMan5.2 software provided by Cochrane Collaboration.Results:Two hundred and fifty-seven articles were searched out.After screening,12 articles(752 patients)were included in the final analysis,416 patients in experimental group and 336 patients in control group.The results of Meta-analysis revealed that the postoperative patellar height(measured by Caton-Deschamps method,Blackburne-Peel method and Insall-Salvati method)and the postoperative complication incidence were lower in experimental group compared to control group(I2=0%,P=0.610,MD=-0.05,95%CI(-0.07,-0.02),P=0.001; I2=22%,P=0.280,MD=-0.06,95%CI(-0.10,-0.03),P=0.003; I2=88%,P=0.000,MD=-0.08,95%CI(-0.11,-0.05),P=0.000; I2=0%,P=0.960,MD=0.24,95%CI(0.07,0.83),P=0.020).There was no statistical difference in postoperative Hospital for Special Surgery(HSS)knee function score and posterior tibial slope between experimental group and control group(I2=73%,P=0.030,MD=1.01,95%CI(-1.24,3.25),P=0.380; I2=0%,P=0.600,MD=0.16,95%CI(-0.22,0.54),P=0.420).Conclusion:MOWHTO above the tibial tuberosity is similar to MOWHTO below the tibial tuberosity in clinical outcome in treatment of medial compartment KOA,however,the former displays the advantage as higher safety and the disadvantage as more likely to cause postoperative patella baJa compared to the latter.

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備注/Memo

備注/Memo:
基金項(xiàng)目:廣東省中醫(yī)藥局科研項(xiàng)目(20211035,20211023); 廣州市科技計(jì)劃項(xiàng)目(202002030204)
通訊作者:劉文剛 E-mail:[email protected]
更新日期/Last Update: 2022-02-20