活动平台与固定平台单髁置换治疗内侧膝骨关节炎的Meta分析

目的:系统评价活动平台(mobile-bearing,MB)单室膝关节置换术(unicompartmental knee arthroplasty,U-KA)与固定平台(fix-bearing,FB)UKA治疗膝骨关节炎的疗效.方法:通过计算机检索2000年1月至2020年4月PubMed数据库,CNKI中国期刊全文数...

META analysis of mobile bearing and fixed bearing unicondyle replacement for medial knee osteoarthritis

Objective: To evaluate of the clinical effects of mobile-bearing(MB) and fixed-bearing(FB) unicompartmental knee arthroplasty(UKA) in the treatment of knee osteoarthritis by Meta-analysis.Methods: The literature on FB UKA and MB UKA in the treatment of knee osteoarthritis in PubMed,CNKI,Wanfang,Cochrane and EMBASE database were searched by computer from January 2000 to April 2020. According to the inclusion and exclusion criteria,two authors were selected independently and the selected literature was evaluated for quality.After literature data were extracted,Review Manager 5.3 software was used to analyze knee function score,postoperative activity,revision rate,polyethylene wear rate,pad dislocation,aseptic loosening,postoperative pain,knee arthritis progression,mechanical shaft alignment of lower limbs,and imaging clarity line respectively.Results: A total of 13 literatures were included in this meta-analysis,including 2 randomized controlled studies and 11 cohort studies. A total of 1 871 patients were included,including 913 in FB UKA group and 958 in MB UKA group. Meta analysis results showed that:postoperative knee joint function scoreMD=-0.84,95%CI(-1.46,-0.21),P=0.008] and postoperative knee joint range of motionMD=-1.51,95%CI(-2.84,-0.18),P=0.03] in FB UKA group were better than those in MB UKA group. Compared with FB UKA group,MB UKA group had a higher lower limb mechanical axis alignment rateOR=2.08,95%CI(1.27,3.39),P=0.003],and the wear rate of polyethyleneOR=0.11,95%CI(0.01,0.91),P=0.04] was lower. There were no differences between two groups in the renovation rateOR=1.16,95%CI(0.75,1.80),P=0.50),liner dislocation rateOR=3.78,95%CI(0.93,15.29),P=0.06],aseptic looseningOR=2.11,95%CI(0.81,5.51),P=0.13],postoperative painOR=1.13,95%CI(0.37,3.43),P=0.83],osteoarthritis progressionOR=1.28,95%CI(0.67,2.47),P=0.46)and imaging radiolucent lineOR=1.62,95%CI(0.09,30.22),P=0.75].Conclusion: FB UKA has a higher postoperative functional score and range of motion. MB UKA has more advantages in the correction of lower limb mechanical axis,and the wear rate of polyethylene is also lower. There was no significant difference between the two groups in revision rate,dislocation of the liner,aseptic loosening,postoperative pain,progression of osteoarthritis,and postoperative translucency.