目的:本系统综述检查了所有meta分析的方法学可信度和报告质量,这些分析比较了骨-髌腱-骨(BPTB)和绳肌腱(HT)用于前交叉韧带(ACL)重建(ACLR)。
方法:EMBASE,MEDLINE,对Cochrane图书馆进行了系统的搜索,和两名审核员独立评估资格,根据《医学文献用户指南》的可信度,根据系统评价和荟萃分析(PRISMA)清单的首选报告项目,以及报告的完整性。使用Kappa对评分者之间的协议进行了量化,我们使用皮尔逊相关系数来评估潜在的关联。
结果:确定了17项meta分析,比较了BPTB和HT对ACLR的影响。大多数荟萃分析发表于2011年(5;29%),北美是最常见的出版大陆(6;35%)。最常报告的三个结果是稳定性(82%),并发症(76%),和功能(回到运动,IKDC评分)(71%)。《用户指南》中令人满意地报告的项目的中位数为7个中的3个(IQR2-4)。对于meta分析,PRISMA中令人满意报告的项目的中位数为27个中的20个(IQR19-22)。
结论:比较BPTB和HT自体移植物对ACLR的meta分析的可信度虽然有限,但随着时间的推移而提高。早期的研究在方法上的严谨性有限;然而,最近的研究显示了改进方法的希望。研究结果表明,应根据具体情况做出决策,并在最佳可用证据的背景下协调患者因素和偏好以及外科医生的经验。
方法:IV.
OBJECTIVE: This systematic
review examined the methodological credibility and quality of reporting of all meta-analyses which have compared bone-patellar tendon-bone (BPTB) versus hamstring tendon (
HT) for anterior cruciate ligament (ACL) reconstruction (ACLR).
METHODS: EMBASE, MEDLINE, and The Cochrane Library were systematically searched, and two reviewers independently assessed eligibility, credibility according to the Users\' Guide to medical literature, and completeness of reporting according to the preferred reporting items for systematic
review and meta-analyses (PRISMA) checklist. Inter-rater agreement was quantified using Kappa, and we used Pearson\'s correlation coefficient to evaluate potential associations.
RESULTS: Seventeen meta-analyses were identified comparing BPTB versus
HT for ACLR. The majority of meta-analyses were published in 2011 (5; 29 %), and North America was the most common continent of publication (6; 35 %). The three most commonly reported outcomes were stability (82 %), complications (76 %), and function (return to sport, IKDC score) (71 %). The median number of satisfactorily reported items in the Users\' Guide was three out of seven (IQR 2-4). The median number of satisfactorily reported items in PRISMA for the meta-analyses was 20 out of 27 (IQR 19-22).
CONCLUSIONS: The credibility of the meta-analyses comparing BPTB versus
HT autograft for ACLR although limited is improving with time. Earlier studies had limited methodological rigour; however, the more recent studies have shown promise in improved methodology. The study findings suggest that decisions should be made on a case-to-case basis with coordination of patient factors and preferences as well as surgeon experience on the background of the best available evidence.
METHODS: IV.