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[1]黃龍翔,杜虎羽.LARS人工韌帶重建術(shù)與改良Brostr?m術(shù)治療慢性踝關(guān)節(jié)外側(cè)不穩(wěn)療效和安全性的Meta分析[J].中醫(yī)正骨,2023,35(09):30-36.
　HUANG Longxiang,DU Huyu.Clinical outcomes and safety of LARS artificial ligament reconstruction versus modified Brostr?m procedure for treatment of chronic lateral ankle instability:a meta-analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(09):30-36.
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LARS人工韌帶重建術(shù)與改良Brostr?m術(shù)治療慢性踝關(guān)節(jié)外側(cè)不穩(wěn)療效和安全性的Meta分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期數(shù):
2023年09期
頁(yè)碼:
30-36
欄目:
文獻(xiàn)研究
出版日期:
2023-09-20

文章信息/Info

Title:
Clinical outcomes and safety of LARS artificial ligament reconstruction versus modified Brostr?m procedure for treatment of chronic lateral ankle instability:a meta-analysis
作者:
黃龍翔1; 杜虎羽2
1.山西醫(yī)科大學(xué)第九臨床醫(yī)學(xué)院,山西 太原 030606; 2.太原市中心醫(yī)院,山西 太原 030009
Author(s):
HUANG Longxiang1; DU Huyu2
1.The Ninth Clinical Medical College of Shanxi Medical University,Taiyuan 030606,Shanxi,China 2.Taiyuan Central Hospital,Taiyuan 030009,Shanxi,China
關(guān)鍵詞:
踝損傷;  踝關(guān)節(jié);  關(guān)節(jié)不穩(wěn)定性;  韌帶增強(qiáng)重建系統(tǒng);  改良Brostr?m術(shù);  專題Meta分析
Keywords:
ankle injuries;  ankle joint;  joint instability;  ligament augmentation reconstruction system;  modified Brostr?m;  meta-analysis as topic
摘要:
目的:系統(tǒng)評(píng)價(jià)韌帶增強(qiáng)重建系統(tǒng)(ligament augmentation reconstruction system,LARS)人工韌帶重建術(shù)和改良Brostr?m術(shù)治療慢性踝關(guān)節(jié)外側(cè)不穩(wěn)(chronic lateral ankle instability,CLAI)的療效和安全性。方法:應(yīng)用計(jì)算機(jī)檢索中國(guó)知網(wǎng)、維普網(wǎng)、萬(wàn)方數(shù)據(jù)庫(kù)、中國(guó)生物醫(yī)學(xué)文獻(xiàn)服務(wù)系統(tǒng)、Pubmed、Cochrane Library、Embase從數(shù)據(jù)庫(kù)建庫(kù)至2022年10月31日收錄的比較LARS人工韌帶重建術(shù)(試驗(yàn)組)與改良Brostr?m術(shù)(對(duì)照組)治療CLAI的有效性和安全性的隨機(jī)對(duì)照試驗(yàn)研究文獻(xiàn)。由2名研究者獨(dú)立按照納入和排除標(biāo)準(zhǔn)對(duì)相關(guān)文獻(xiàn)進(jìn)行篩選和數(shù)據(jù)提取,并采用Cochrane偏倚風(fēng)險(xiǎn)評(píng)估工具對(duì)納入研究的文獻(xiàn)進(jìn)行質(zhì)量評(píng)估。采用RevMan5.4軟件進(jìn)行Meta分析。結(jié)果:共檢索到692篇文獻(xiàn),通過(guò)逐層篩選最終納入7篇文獻(xiàn),其中英文文獻(xiàn)5篇、中文文獻(xiàn)2篇。Meta分析結(jié)果顯示,試驗(yàn)組手術(shù)時(shí)間、重返運(yùn)動(dòng)時(shí)間均短于對(duì)照組[MD=-6.81,95%CI(-12.59,-1.03),P=0.020; MD=-5.02,95%CI(-6.40,-3.64),P=0.000],距骨前移距離小于對(duì)照組[MD=-0.42,95%CI(-0.71,-0.14),P=0.003]; 2組并發(fā)癥發(fā)生率、足踝預(yù)后評(píng)分、足踝功能量表評(píng)分、距骨傾斜角比較,組間差異均無(wú)統(tǒng)計(jì)學(xué)意義[OR=0.53,95%CI(0.25,1.15),P=0.110; MD=8.55,95%CI(-1.29,18.39),P=0.090; MD=2.87,95%CI(-4.64,10.38),P=0.450; MD=-0.45,95%CI(-1.21,0.31),P=0.250]。結(jié)論:現(xiàn)有的證據(jù)表明,LARS人工韌帶重建術(shù)治療CLAI在踝關(guān)節(jié)功能恢復(fù)和安全性方面與改良Brostr?m術(shù)相當(dāng),但前者在踝關(guān)節(jié)穩(wěn)定性、手術(shù)時(shí)間、重返運(yùn)動(dòng)時(shí)間方面更具優(yōu)勢(shì)。
Abstract:
Objective:To systematically review the clinical outcomes and safety of artificial ligament reconstruction using the ligament augmentation reconstruction system(LARS)versus modified Brostr?m procedure in treatment of chronic lateral ankle instability(CLAI).Methods:All the randomized controlled trial(RCT)articles about the clinical outcomes and safety of LARS artificial ligament reconstruction(experimental group)versus modified Brostr?m procedure(control group)for treatment of CLAI included from database establishing to October 31,2022 were retrieved from China National Knowledge Internet,Vip Database,Wanfang Database,Chinese Biomedical Literature Service System,Pubmed,Cochrane Library and Embase through computer.The pertinent articles were screened and the information was extracted independently by two researchers according to the inclusion and exclusion criteria.The methodological quality of researches in the included articles was evaluated by using Cochrane bias risk assessment tools,and then a Meta-analysis was conducted by using RevMan5.4 software.Results:Six hundred and ninety-two articles were searched out.After screening,7 articles were included in the final analysis,including 5 English articles and 2 Chinese articles.The results of Meta-analysis revealed that the operative time and time to return to preinjury activity level(RTPAL)were shorter,the anterior talar translation(ATT)was smaller in experimental group compared to control group(MD=-6.81,95%CI(-12.59,-1.03),P=0.020; MD=-5.02,95%CI(-6.40,-3.64),P=0.000; MD=-0.42,95%CI(-0.71,-0.14),P=0.003).There was no statistical difference in the postoperative complication incidence,foot and ankle outcome score(FAOS),foot and ankle ability measure(FAAM)score and talar tilt angle(TTA)between the 2 groups(OR=0.53,95%CI(0.25,1.15),P=0.110; MD=8.55,95%CI(-1.29,18.39),P=0.090; MD=2.87,95%CI(-4.64,10.38),P=0.450; MD=-0.45,95%CI(-1.21,0.31),P=0.250).Conclusion:Available evidences suggest that LARS artificial ligament reconstruction is similar to modified Brostr?m procedure in ankle function recovery and safety in treatment of CLAI,while the former has advantages over the latter in ankle stability,operative time and time to RTPAL.

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通訊作者:杜虎羽 E-mail:[email protected]
更新日期/Last Update: 1900-01-01