随机对照试验评估LET和ALL在ACLR中的前侧旋转不稳定性是脆弱的:系统性审查
Avanish Yendluri1, Christopher Gonzalez1, Niklas H Koehne1
1Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Sports health
|August 7, 2025
概括
在前交叉带重建 (ACLR) 过程中对侧侧额外关节缩 (LET) 和前侧带 (ALL) 重建的研究结果在统计学上很脆弱. 需要更强大的试验来确认它们的临床意义.
科学领域:
- 整形外科手术 整形外科手术
- 运动医学 运动医学
- 生物机械工程 生物机械工程
背景情况:
- 前交叉带重建 (ACLR) 经常被增强为侧向外关节缩 (LET) 或前侧带 (ALL) 重建.
- 这些增强的目的是解决前侧侧旋转不稳定的问题.
- 这些程序的临床意义需要强大的统计验证.
研究的目的:
- 评估在随机对照试验 (RCT) 中报告的结果的统计稳定性,评估在ACLR期间的LET和ALL重建.
- 通过脆弱指数 (FI) 和脆弱系数 (FQ) 来确定报告结果的脆弱性.
主要方法:
- 在PubMed,Embase和MEDLINE系统搜索2010年至2024年间发表的RCT.
- 包括在ACLR期间评估LET和/或ALL重建作为增强的RCT.
- 计算FI/反向FI (rFI) 和FQ,用于17个RCT中51个报告结果.
主要成果:
- 中位数FI为4,中位数FQ为0.031,表明统计学上脆弱的结果.
- 从统计学上显著的结果比不显著的结果 (中位数FQ0.038) 更脆弱 (中位数FQ0.015).
- 在60.8%的结果中,患者对随访的损失超过了结果的脆弱性指数.
结论:
- 在RCT中报告的LET和ALL增强ACLR的结果在统计学上是脆弱的.
- 需要更多充足的RCT来确定这些前侧增强技术的真正临床意义.
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