前十字带重建的比较结果,带有和没有侧向外关节:一个元分析
Yi Zhang1, Sharon Si Heng Tan1, Andrew Kean Seng Lim1
1Department of Orthopaedic Surgery, National University Health System, Singapore City, Singapore.
概括
在前交叉带重建 (ACLR) 中添加侧部外关节带 (LET) 改善膝盖稳定性并减少移植重裂. 然而,功能性结果,如恢复运动和患者报告的得分,与单独使用ACLR相比没有显著差异.
科学领域:
- 整形外科手术 整形外科手术
- 运动医学运动医学
- 膝盖生物力学 膝盖生物力学
背景情况:
- 前交叉带重建 (ACLR) 旨在恢复膝盖功能,但面临着旋转不稳定性和移植重裂等挑战.
- 侧侧关节外延展 (LET) 是一种用于增强ACLR的技术,有可能改善前侧膝盖稳定性.
- 有关LET手术后潜在的过度约束和早期骨关节炎存在担忧.
研究的目的:
- 为了比较ACLR的临床,功能和患者报告的结果,添加LET或不添加LET.
- 评估LET在控制旋转松和降低移植重裂率方面的有效性.
- 评估两种手术方法之间功能恢复和患者满意度的潜在差异.
主要方法:
- 进行了对研究的系统审查,比较了带有和没有LET的ACLR.
- 从包括的研究中提取了临床结果,功能表现和患者报告的措施的数据.
- 采用随机效应模型,对三项或更多研究报告的结果进行估计,并在整个研究中评估研究质量.
主要成果:
- 分析了27项涉及3225名患者的研究.
- 与LET配合的ACLR显著改善了松性减少 (KT1000) 和前部翻译控制.
- LET显著降低了移植失败/重新破裂率 (RR 0.93),但在体育或主观患者报告结果方面没有发现显著差异 (IKDC,Lysholm,Tegner).
结论:
- 将LET添加到ACLR导致更好的临床结果,特别是在膝盖松和移植稳定性方面.
- 尽管改善了临床措施,但LET并没有显著提高与恢复运动或主观患者满意度相关的功能结果.
- 可能需要进一步的研究,以充分了解LET在ACLR中的长期影响和最佳适应症.
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