骨关节炎患者全膝关节置换术髌骨置换与否的临床效果比较:meta分析

目的采用meta分析比较膝关节置换手术的骨关节炎患者进行髌骨置换与否的临床效果,为临床治疗提供参考。方法全面检索PubMed(1966年1月至2010年12月)、EMBASE 1969年1月至2010年12月)和Cochrane Libray数据库,筛选出在行全膝关节置换术的骨关节炎患者中髌骨置换与否比较的随机对照试验(RCTs)进行分析,比较其膝前痛的发生情况、翻修率及再手术率等。结果最终筛选出9个独立的随机临床试验。从这些试验分析表明,髌骨置换与保留组之间膝前痛发生情况、翻修率和再手术率差异无统计学意义。结论髌骨置换没有显著减少膝前痛、翻修率、再手术率等并发症,没有为接受全膝关节置换术的骨关节炎患者提供更好的疗效。

Clinical efficacies of resurfacing and non-resurfacing patella in total knee arthroplasty for osteoarthritis:a meta-analysis

ObjectiveThe compare the clinical efficacies of resurfacing and non-resurfacing the patella in primary total knee arthroplasty (TKA) in osteoarthritis patients, so as to provide evidence for clinical practice.MethodsA comprehensive search for relevant studies was performed in PubMed (January 1966 to December 2010), EMBASE(1969 January to December 2010) and the Cochrane Libray databases. Only randomized control trials comparing the outcomes (incidence of anterior knee pain, revision rate, and reoperation rate, etc.) of resurfacing and nonresurfacing patella in patients undertaking primary TKA were included in the present analysis. ResultsNine independent randomized clinical trials were finally identified. Analysis of these trials showed that patellar resurfacing failed to make significant difference in incidence of anterior knee pain, revision rate, or reoperation rate compared with the non-surfacing group.ConclusionPatellar resurfacing can not reduce the incidence of anterior knee pain, revision rate, or reoperation rate in patients undergoing primary TKA, and therefore can not contribute to a better outcome in these patients.