网络首发:2014-07-20,
纸质出版:2014
移动端阅览
保守和手术治疗急性髌骨脱位的Meta分析[J]. 中山大学学报(医学科学版), 2014,35(4).
Conservative Versus Surgical Interventions for Treating Acute Patellar Dislocation:A Meta-analysis[J]. Journal of Sun Yat-sen University (Medical Sciences), 2014, 35(4).
【目的】 通过Meta分析,探讨保守和手术两种方法治疗急性髌骨脱位的临床疗效有无差异。【方法】 在PubMed、Cochrane图书馆、MEDLINE、EMBase等数据库(均截止至2014年2月)中检索比较保守和手术治疗急性髌骨脱位的随机对照研究,使用RevMan5.2 软件进行Meta 分析。临床指标为髌骨脱位复发率、髌骨半脱位的复发率、Kujala评分、再次手术率以及膝关节不稳等情况。【结果】 纳入8篇随机对照研究(400例),Meta分析结果显示:对于急性髌骨脱位患者,两种治疗方法在半脱位复发率(RR= 0.73,95%CI:0.46-1.15)、Kujala评分(WMD=5.56,95%CI:-3.54-14.67)、再次手术率(RR = 1.09,95%CI:0.72-1.65)、膝关节不稳症状发生率(RR= 0.57,95%CI:0.25-1.30)等方面差异均无统计学意义(P > 0.05),手术治疗后脱位复发率(RR = 0.65,95%CI:0.48-0.88)低于保守治疗,且2年随访期内,手术治疗Kujala评分(WMD=13.94,95%CI:5.36-22.52)方面优于保守治疗(P< 0.05)。【结论】 对于急性髌骨脱位,手术治疗后脱位复发率较保守治疗低,且膝关节短期功能恢复及稳定性优于保守治疗,但是保守和手术两种治疗方法在膝关节Kujala评分、半脱位复发率、再次手术率以及膝关节不稳症状发生率方面并无统计学差异。
【Objective】The purpose of this review was to assess the clinical outcomes ofsurgical, compared with non-surgical interventions, fortreating people with acute patellar dislocation. 【Methods】 We searched the PubMed,Cochrane Library, MEDLINE, EMBASE (from beginning to February 2014) for the randomizedcontrolled trials and clinical trials on comparison of surgical versus conservativeinterventions for acute patellar dislocation. Meta analysis was conducted usingthe RevMan5.2 software. The risk of recurrent dislocation/subluxation, Kujala scores,subsequent surgery rate and patient-reported instabilitysymptoms were observed after treated with surgical and conservative treatment methods.【Results】 Eight randomized controlled trials were included involving 400 patientsmet the criteria of the present study. Four trials present to be high quality RCTs.Follow-up was a minimum of two years in five studies andbetween five and seven years in three studies. Meta analysis results showed thatthere was no significant difference between surgical and conservative group of acutepatellar dislocation in the risk of recurrent subluxation (RR=0.73, 95%CI: 0.46-1.15),Kujala scores (WMD=5.56, 95%CI:-3.54-14.67), subsequent surgery rate (RR=1.09, 95%CI:0.72-1.65) and patient-reported instability symptoms (RR=0.57,95%CI: 0.25-1.30) (P > 0.05), surgical treatment was superior than conservativein the risk of recurrent disloacation (RR=0.65, 95%CI: 0.48-0.88). Further analysiswas performed between the short-term 2 years follow-up group and long-term 5-7 years follow-up group, and found that only in the short-term2 years follow-up group, Kujala scores (WMD=13.94, 95%CI:5.36-22.52) of surgical group were better than that of the conservative group (P< 0.05). 【Conclusion】 For patients with acute patellar dislocation, the surgicaltreatment has a lower risk of recurrent dislocation and a quicker recovery of theknee function, but surgical treatment result is equivalent to conservative treatmentin Kujala score, risk of recurrent subluxation, and patient-reportedinstability symptoms.
0
浏览量
581
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010802024621
