关节镜下经胫骨隧道入路与前内侧入路重建前交叉韧带效果的Meta分析

背景：一些随机对照研究试图回答关节镜下经胫骨骨道入路与前内侧入路重建前交叉韧带疗效优劣问题，得出结论各不相同。目的：关节镜下经胫骨骨道入路与前内侧入路重建前交叉韧带疗效Meta分析。方法：计算机检索PubMed、Embase、Cochrane图书馆及中国生物医学数据库、维普信息数据库、万方数据库，手工检索相关的中英文骨科杂志。收集关节镜下经胫骨骨道入路与前内侧入路重建前交叉韧带的对照试验，并评价纳入研究的方法学质量。统计软件用Cochrane协作网提供的RevMan 5.0。结果与结论：共纳入7个研究。Meta分析表明，与胫骨骨道入路相比，前内侧入路制作的股骨隧道的长度较短[RR 3.91，95%CI(1.49，6.34)]、[RR 12.73，95%CI(11.91，13.55)]、股骨隧道冠状面骨道角度较垂直[RR 18.18，95%CI(17.10，19.25)]、胫骨矢状面胫骨隧道位置较靠前[RR 6.16，95%CI(5.23，7.10)]、术后膝关节Lysholm功能评分高[RR 6.16，95%CI(-3.59，-2.63)]，差异有显著性意义。分析结果说明，关节镜下通过前内侧入路比经胫骨隧道入路重建前交叉韧带更接近解剖重建，修复疗效更好。 中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Arthroscopic anterior cruciate ligament reconstruction through transtibial and anteromedial approaches: a Meta-analysis

BACKGROUND: Some randomized controlled trials attempt to answer the advantages and disadvantages of arthroscopic anterior cruciate ligament reconstruction through transtibial and anteromedial approaches, but there are no consistent findings. OBJECTIVE: To conduct a Meta-analysis on the effectiveness of arthroscopic anterior cruciate ligament reconstruction via transtibial and anteromedial approaches. METHODS: PubMed, Embase, Cochranel Library, CBMdisc, VIP and WanFang were searched by computer, and relevant Chinese and English orthopedic journals were retrieved manually. Controlled trials related to the effectiveness of arthroscopic anterior cruciate ligament reconstruction via the transtibial and anteromedial approaches were included. The methodological quality of trials was critically assessed. RevMan 5.0 software was used for data analysis．RESULTS AND CONCLUSION: Seven articles were included. Meta-analysis results showed that there were significant differences between the transtibial and anteromedial approaches in the following aspects: femoral tunnel length [relative risk (RR) 3.91, 95% confidence interval (CI) (1.49, 6.34); RR=12.73, 95%CI (11.91, 13.55)]; tunnel orientation in coronal plane (°) [RR=18.18, 95%CI (17.10, 19.25)]; tibial tunnel orientation in sagittal plane [RR=6.16, 95%CI (5.23, 7.10)], postoperative Lysholm score [RR=6.16, 95%CI (-3.59, -2.63)]. These findings indicate that arthroscopic anterior cruciate ligament reconstruction via the transtibial approaches is better than that via the anteromedial approaches.