[Meta analysis of unilateral condylar replacement and high tibial osteotomy in the treatment of medial compartment osteoarthritis of the knee].
[Meta analysis of unilateral condylar replacement and high tibial osteotomy in the treatment of medial compartment osteoarthritis of the knee].
复制标题
DOI：
10.3969/j.issn.1003-0034.2018.12.017
复制
发表时间：
2018-12-25
影响因子：
--
通讯作者：
Pang, Qing-Jiang
中科院分区：
文献类型：
--
作者：
Fu, You-Wei;Liu, Bing-Gen;Pang, Qing-Jiang
目的：应用Meta分析方法比较胫骨高位截骨术(HTO)和单髁关节置换术(UKA)治疗内侧室骨关节炎(MIOA)的临床疗效，为MIOA患者提供更好的手术选择。方法：应用计算机检索Cochrane图书馆(2017年第6期)、PubMed、Ovid、ELSIVE、CNKI和万方数据库。按纳入标准检索并筛选1970年1月1日至2017年6月30日有关MIOA的HTO和UKA的文献，包括并发症、膝关节评分、膝关节活动度、翻修率和优良率，并进行严格的质量评价。采用Cochrane Collaboration Network提供的Revman 5.0软件对纳入的研究结果进行Meta分析并检验数据的异质性。结果：共有13篇文章符合纳入标准，总样本量为1 043篇。其中HTO治疗组462例，UKA治疗组581例。HTO治疗组与UKA治疗组术前膝关节活动度[WMD=6.55，95%CI(1.44，11.66)]、Lysholm膝关节评分[WMD=-3.15，95%CI(-4.77，-1.53)]、并发症[WMD=2.78，95%CI(1.52，5.11)]、翻修率[WMD=1.81，95%CI(1.17，2.80)]、并发症发生率[WMD=3.21，95%CI(1.13，9.10)]、术前膝关节活动度[WMD=6.55，95%CI(1.44，11.66)]、Lysholm膝关节评分[WMD=-3.15，95%CI(-4.77，-1.53)]、并发症[WMD=2.78，95%CI(1.52，5.11)]、翻修率[WMD=1.81，95%CI(1.17，2.80)]，差异有统计学意义。优良率[WMD=0.49，95%CI(0.30，0.80)]，股骨胫骨角度变化[WMD=-2.37，95%CI，(-3.63，-1.11)](P<0.05)。结论：从近期和中期的临床疗效比较，胫骨高位截骨术是治疗内侧筋膜间室骨关节炎的较好选择，远期临床疗效有待进一步研究。
OBJECTIVE: Meta-analysis was used to compare the clinical efficacy of high tibial osteotomy(HTO) and unicondylar arthroplasty (UKA) in the treatment of medial compartment osteoarthritis (MIOA) and provide a better surgical choice for patients with MIOA.METHODS: The Cochrane Library (Issue 6, 2017), PubMed, Ovid, ELSIVE, CNKI and Wanfang databases were searched by a computer. Literatures on HTO and UKA for MIOA from January 1, 1970 to June 30, 2017, including complications, knee joint score, knee mobility, revision rate and excellent and good rate, were searched and screened out according to the inclusion criteria, and strict quality evaluation was carried out. RevMan 5.0 software provided by Cochrane collaboration network was used to conduct the meta-analysis of the included research results and to test the heterogeneity of the data.RESULTS: Total 13 articles met the inclusion criteria, and the total sample size was 1 043. Among them, 462 were HTO treatment group and 581 were UKA treatment group. By comparison between HTO treatment group and UKA treatment group, there were significant differences in the contralateral deterioration rate[WMD=3.21, 95%CI(1.13, 9.10)], pre-operative knee range of motion[WMD=6.55, 95%CI(1.44, 11.66)], Lysholm knee score[WMD=-3.15, 95%CI(-4.77, -1.53)], complications[WMD=2.78, 95%CI(1.52, 5.11], revision rate[WMD=1.81, 95%CI(1.17, 2.80)], the rate of excellent and good[WMD=0.49, 95%CI(0.30, 0.80)], and femorotibial angle changes[WMD=-2.37, 95%CI, (-3.63, -1.11)](P0.05).CONCLUSIONS: Based on the limited data, high tibial osteotomy is a better choice for the treatment of medial compartment osteoarthritis in the comparison of short and medium-term clinical outcomes, and long-term clinical outcomes may need further study.