在退行性疾病中关节置换:系统性审查
Víctor Ravelo1,2, Erick Vargas3,4, Henry García Guevara5,6
1Grupo de Investigación de Pregrado en Odontología (GIPO), Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Temuco 4780000, Chile.
Journal of clinical medicine
|January 25, 2025
概括
总关节 (TMJ) 置换显著改善功能,并减少患有退行性或炎症性关节疾病的患者的疼痛. 手术后,患者经历了口腔开口的增强,并且可以食用固体食物,这表明了有利的长期结果.
科学领域:
- 口腔和牙面部外科手术
- 类风湿病学 类风湿病学
- 生物材料科学 生物材料科学
背景情况:
- 退行性和炎症性关节疾病显著损害了关节 (TMJ) 功能,往往导致严重的疼痛和有限的下运动.
- 晚期TMJ疾病的当前治疗选择可能无法完全恢复功能或缓解症状,需要先进的干预措施.
研究的目的:
- 在患有退行性和/或炎症性关节疾病的患者中系统地审查和分析TMJ全置换术的指示和临床结果.
- 确定与全关节置换相关的患者个人资料和干预条件.
主要方法:
- 根据Cochrane和PRISMA指南进行了全面的系统审查,搜索主要数据库 (PubMed,Embase,Scopus,Web of Science) 和从1997年到2024年7月的灰色文献.
- 包括的研究涉及超过15年的患有退行性/炎症性关节疾病的患者,他们接受了整体关节假肢置换,经过至少12个月的术后随访.
- 使用ROBINS-I评估偏差风险,使用GRADEpro.pro评估证据质量.
主要成果:
- 在579名患有退行性/炎症性TMJ疾病的参与者中,骨关节炎是最常见的诊断.
- 在手术前,参与者的口腔口径平均为24.32毫米,经历了中度至严重的疼痛 (76.18%),需要软/液体饮食.
- 由于系统故障而显示的全关节置换仅在4.07%的情况下发生.
结论:
- 整体关节置换显示了有利的长期结果,所有参与者报告了手术后疼痛减少或不存在.
- 患者体验到下功能得到改善,口腔平均开口增加到40.74毫米,饮食转向固体食物.
- 整体关节置换手术的最佳时间尚不清楚,无论疾病持续时间,非手术治疗史或之前的手术.
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