自体腘绳肌腱双束与单束重建前交叉韧带效果的Meta分析  

Meta-analysis on double-bundle versus single-bundle autoallergic hamstring for the reconstruction of anterior cruciate ligament

作　　者：徐明明[1] 于晓华[2] 罗茜[2] 马传雨[1] 赵竹英[2] 

机构地区：[1]江苏大学临床医学院,江苏省镇江市212013 [2]解放军第101医院南京军区军事训练医学研究所,江苏省无锡市214044

出　　处：《中国组织工程研究》2013年第4期744-749,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:选择双束还是单束自体腘绳肌腱重建前交叉韧带,目前仍存在很大争议。目的:系统评价自体腘绳肌腱双束与单束重建前交叉韧带的临床疗效。方法:计算机检索PubMed、Cochranelibrary、Springerlink、CNKI、CBM等数据库,收集自体腘绳肌腱双束对比单束重建前交叉韧带的临床随机对照试验,采用Jadad量表对所纳入研究的方法学质量进行评价,并提取数据资料,使用RevMan5.0软件对数据进行Meta分析。结果与结论:纳入临床随机对照试验15篇,共1008例患者符合纳入标准,Meta分析结果显示:双束重建与单束重建后KT测量值的差异有显著性意义[WMD=-0.51,95%CI(-0.74,-0.28),P<0.0001];重建后轴移试验阴性的差异有显著性意义[RR=1.27,95%CI(1.11,1.45),P=0.0003];重建后Lysholm膝关节评分的差异有显著性意义[WMD=-2.10,95%CI(-3.65,-0.55),P=0.008];重建后IKDC分级评分的差异无显著性意义[RR=1.04,95%CI(0.99,1.06),P=0.10]。双束自体腘绳肌腱重建前交叉韧带对于恢复膝关节稳定性优于单束重建,而对于恢复膝关节功能两者疗效差异不大。BACKGROUND： Doctors often use autoallergic hamstring double-bundle and single-bundle for the reconstruction of anterior cruciate ligament, but there is a controversy on which method is better. OBJECTIVE： To evaluate the clinical outcome of double-bundle versus single-bundle autoallergic hamstring for the reconstruction of anterior cruciate ligament. METHODS： Randomized controlled trials about comparing double-bundle with single-bundle autoallergic hamstring for the reconstruction of anterior cruciate ligament were collected from PubMed database, Cochrane library, Springerlink database, CNKI database and CBM database. The Jadad＇s scale was used to assess the methodological quality of the randomized controlled trials and Cochrane collaboration＇s RevMan 5.0 software was used to perform the Meta analysis. RESULTS AND CONCLUSION： Fifteen randomized controlled trials totally 1 008 patients met the inclusion criteria and included. Meta-analysis results showed that there was statistical difference of postoperative KT-1000 or KT-2000 arthrometer mesurement between double-bundle and single-bundle reconstruction [weighted mean difference （WMD）=-O.51, 95% confidence interval （CI） （-0.74, -0.28）, P 〈 0.000 1], there was significant difference of the negative pivot-shift testing [relative risk （RR）=1.27, 95%C1（1.11,1.45）, P=0.000 3], as well as the postoperative Lysholm scores [WMD=-2,10, 95%C/（-3.65, -0.55）, P=0.008]. But there was no statistical differences of IKDC final score [RR=1.04, 95%C/（0.99, 1.06）, P=0.10]. The double-bundle autoallergic hamstring is superior to single-bundle for anterior cruciate ligament reconstruction on recovering stability of knee joint, but they are similar in recovering the functions of knee joint.

关 键 词：骨关节植入物 骨关节植入物循证医学 膝关节 前交叉韧带 自体腘绳肌腱 双束 单束 META分析 

分 类 号：R318[医药卫生—生物医学工程]