背景:这项比较研究的荟萃分析的目的是更新目前关于全膝关节内外侧入路置换(TKA)治疗膝关节外翻畸形的功能和影像学结果以及并发症的证据。
方法:PubMed,MEDLINE,Scopus,使用CochraneCentral数据库搜索关键词,共纳入10项研究.评估纳入研究的方法学质量。用于定量分析的数据包括膝关节社会评分(KSS),运动范围(ROM),手术时间,髋-膝-踝角度(HKA),以及并发症的数量和类型。随机和固定效应模型用于汇总均值差异(MD)和比值比(OR)的荟萃分析。采用了Mantel-Haenszel方法。
结果:共确定了1008名患者,其中689和319例接受TKA治疗外翻膝关节畸形,采用外侧和内侧入路,分别。外侧和内侧入路的平均年龄为70±9.5岁和67.3±9.6岁,分别。外侧和内侧入路组的平均随访时间为37.8±21.9和45.9±26.7个月,分别。发现内侧入路的功能结果明显更高,通过术后KSS测量(MD=1.8,95%CI[0.48,3.12],P=0.007)和屈曲ROM(MD=3.12,95%CI[0.45,5.79],P=0.02)。然而,这两个差异均低于最小的临床重要差异.可比较的手术时间和术后HKA角度值(MD=0.22,95%CI[-0.30,0.75],发现两种手术入路之间的P=0.40)。假体周围感染的发生率,骨折,短暂性腓骨神经损伤,深静脉血栓形成具有可比性。
结论:这项比较研究的荟萃分析显示,当外侧和内侧入路用于全膝关节置换术治疗膝关节外翻畸形时,在KSS和ROM方面具有可比性的功能结果,手术时间,和术后髋-膝-踝角度值可以预期。假体周围感染率相似,骨折,腓骨神经损伤也被发现。
方法:I.
■CRD42023392807。
BACKGROUND: The aim of this meta-analysis of comparative studies was to update the current evidence on functional and radiographic outcomes and complications between medial and lateral approaches for total knee arthroplasty (TKA) for valgus knee deformity.
METHODS: The PubMed, MEDLINE, Scopus, and the Cochrane Central databases were used to search keywords and a total of ten studies were included. The methodological quality of the included studies was assessed. Data extracted for quantitative analysis included the Knee Society score (KSS), range of motion (ROM), surgical time, hip-knee-ankle angle (HKA), and number and types of complications. Random- and fixed-effect models were used for the meta-analysis of pooled mean differences (MDs) and odds ratios (ORs). The Mantel-Haenszel method was adopted.
RESULTS: A total of 1008 patients were identified, of whom 689 and 319 underwent TKA for valgus knee deformity with lateral and medial approach, respectively. The mean age was 70 ± 9.5 and 67.3 ± 9.6 years for the lateral and medial approaches, respectively. The mean follow-up was 37.8 ± 21.9 and 45.9 ± 26.7 months for the lateral and medial approach groups, respectively. Significantly higher functional outcomes were found for the medial approach, as measured by the postoperative KSS (MD = 1.8, 95% CI [0.48, 3.12], P = 0.007) and flexion ROM (MD = 3.12, 95% CI [0.45, 5.79], P = 0.02). However, both of these differences were lower than the minimal clinically important difference. Comparable surgical time and postoperative HKA angle values (MD = 0.22, 95% CI [- 0.30, 0.75], P = 0.40) between the two surgical approaches were found. The incidence of periprosthetic joint infections, fractures, transient peroneal nerve injuries, and deep vein thrombosis was comparable.
CONCLUSIONS: This meta-analysis of comparative studies showed that when lateral and medial approaches are used for total knee arthroplasty for valgus knee deformity, comparable functional outcomes in terms of the KSS and ROM, surgical time, and postoperative hip-knee-ankle angle values can be expected. Similar rates of periprosthetic joint infection, fracture, and peroneal nerve injury were also found.
METHODS: I.
UNASSIGNED: CRD42023392807.