人工韧带与自体肌腱重建前交叉韧带的meta分析

目的 系统评价LARS人工韧带及自体移植物在前交叉韧带重建中的安全性和有效性.方法 通过检索PubMed数据库、中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBMdisc)、万方数据库获得已公开发表的LARS人工韧带与自体移植物进行前交叉韧带重建的文献.提取相关数据进行meta分析.结果 本研究共纳入了9篇文献,总病例数456例,结果显示LARS人工韧带术后患者膝关节Lysholm评分及Tegner评分较术前有明显提高(Lysholm:MD=50.05,95 ％CI 48.41～51.68;Tegner:MD=4.41,95％CI 3.40～5.42);并且在术后2年其Lysholm评分及Tegner评分改善较自体肌腱移植仍更明显(Lysholm:MD=0.20,95％CI 0.04～0.35;Tegner:MD=0.18,95％ CI 0.04～0.32).同时,术后2年LARS人工韧带组滑膜炎等并发症发生率低,与自体移植物无明显差异.结论 LARS人工韧带具有良好的临床疗效和安全性,并且在术后2年其稳定性较自体肌腱移植仍具有明显优势,但该结论仍需长随访、高质量的临床研究进一步证实.

Comparison between LARS system and autografts in anterior cruciate ligament reconstruction: a meta analysis

Objective To compare the clinical efficacy and safety between LARS system and autografts in anterior cruciate ligament (ACL) reconstruction. Methods The PubMed database, China National Knowledge Infrastructure (CNKI), Chinese biomedical literature database (CBMdisc), and Wanfang database were searched to obtain the published article comparing the LARS and autografts for ACL reconstruction. The references of the retrieved articles were also read for related articles. Results A total of 9 articles with 456 cases were included in this study.The results showed that Lysholm and Tegner scores were improved significantly after LARS replacement (Lysholm:MD=50.05, 95% CI 48.41-51.68; Tegner:MD=4.41; 95% CI 3.40-5.42). Compared with autografts, the improvements of Lysholm and Tegner scores for LARS replacement were more significant 2 years postoperatively (Lysholm:MD=0.20, 95% CI 0.04-0.35; Tegner:MD=0.18, 95% CI 0.04-0.32). Meanwhile, complication (such as synovitis) rate of LARS replacement was low 2 years postoperatively, showing no notable difference with that of autograft techniques. Conclusion The LARS artificial ligament is effective and safe for ACL reconstruction. LARS has more advantages than autografts concerning the stability 2 years postoperatively. However, high-quality studies with long-term follow-up are required for further confirmation.