关节镜下LARS人工韧带与自体腘绳肌腱重建前交叉韧带临床疗效比较的meta分析
| 作者: |
1陈文祥,
2谢煜,
1赵建宁,
1包倪荣
1 南方医科大学南京临床医学院/南京军区南京总医院骨科，南京 210002 2 南京中医药大学护理学院，南京 210023 |
| 通讯: |
包倪荣
Email: bnrbnr@sina.com |
| DOI: | 10.3978/j.issn.2095-6959.2017.01.018 |
| 基金: | 江苏省临床医学科技专项基金, BL2012002 |
摘要
目的：系统评价关节镜下LARS人工韧带与自体腘绳肌腱重建前交叉韧带在疼痛的控制和膝关节功能恢复等方面的有效性和安全性。方法：采用计算机和手工检索PubMed，The Cochrane Library，EMBASE，中国知网(CNKI)，维普数据库(VIP)和万方数据库，搜集关节镜下LARS人工韧带与自体腘绳肌腱重建前交叉韧带临床疗效比较的前瞻性临床对照研究文献，检索时限均为从建库至2016年8月。根据渥太华纽卡斯尔标准(Newcastle-Ottawa Scale，NOS)评估纳入的研究方法学质量，采用RevMan 5.3软件进行meta分析。结果：共纳入8项前瞻性临床对照研究，371例前交叉韧带损伤患者。meta分析结果显示：LARS人工韧带移植组与自体肌腱移植组术后6个月Lysholm评分，MD=12.46，95%CI：12.46~15.74，差异有统计学意义(P<0.001)；术后6个月滕纳尔(Tegner)评分，MD=1.72，95%CI：1.45~1.99，P<0.001，差异有统计学意义；术后12个月Lysholm评分，MD=4.31，95%CI：−0.70~9.32，差异无统计学意义(P=0.09)；术后12个月Tegner评分，MD=0.52，95%CI：−0.21~1.24，差异无统计学意义(P=0.16)。结论：在术后6个月时LARS人工韧带移植较自体腘绳肌腱移植进行前交叉韧带重建的效果更好；在术后12个月时，LARS人工韧带移植与自体腘绳肌腱移植进行前交叉韧带重建的疗效相当。
关键词：
前交叉韧带重建
LARS人工韧带
自体腘绳肌腱
meta分析
Comparison of clinical efficacy of anterior cruciate ligament reconstruction by arthroscopy between LARS artificial ligament and autologous hamstring tendon: a meta-analysis
CorrespondingAuthor: BAO Nirong Email: bnrbnr@sina.com
DOI: 10.3978/j.issn.2095-6959.2017.01.018
Abstract
Objective: To systematically evaluate the efficacy and safety on control of pain and functional rehabilitation of knee of anterior cruciate ligament (ACL) reconstruction by arthroscopy between LARS artificial ligament and autologous hamstring tendon. Methods: We electronically searched PubMed, Cochrane Library, EMBASE, CBM, CNKI, VIP and Wanfang Data from inception to August 2016 and manually searched journal of library collection to identify prospective clinical comparative trials about comparison of clinical outcome of ACL reconstruction by arthroscopy between LARS artificial ligament and autologous hamstring tendon. The methodological quality of the included trials was assessed according to Ottawa Newcastle standard. Data were analyzed by RevMan 5.3 software. Results: Eight articles involving 371 patients of ACL were included. Statistical difference has been found in the Lysholm score of 6 months after surgery of ACL reconstruction by arthroscopy between LARS artificial ligament and autologous hamstring tendon (MD=12.46; 95% CI: 12.46—15.74; P<0.001). Statistical difference has been found in the Tegner score of 6 months after surgery of ACL reconstruction by arthroscopy between LARS artificial ligament and autologous hamstring tendon (MD=1.72, 95% CI: 1.45—1.99, P<0.001). There were no statistical difference in the Lysholm score of 12 months after surgery of ACL reconstruction by arthroscopy between LARS artificial ligament and autologous hamstring tendon (MD=4.31, 95% CI: 0.70—9.32, P=0.09). There were no statistical difference which has been found in the Tegner score of more than 12 months after surgery of ACL reconstruction by arthroscopy between LARS artificial ligament and autologous hamstring tendon (MD=0.52, 95% CI: 0.21—1.24, P=0.16). Conclusion: The clinical outcome of ACL reconstruction by arthroscopy between LARS artificial ligament is better than by autologous hamstring tendon six months after surgery. And the clinical outcome is similar 12 months after surgery.