全膝关节表面置换患者应用固定平台和移动平台术后中期临床疗效Meta分析  

Fixed- bearing knee prostheses or mobile- bearing knee prostheses: a meta- analysis on clinical outcome of total knee arthroplasty

作　　者：张博[1] 段王平[1] 郭丽[1] 田瑞媛 李鹏翠[1] 卫小春[1] 

机构地区：[1]山西医科大学第二医院骨科骨与软组织损伤与修复山西省重点实验室,太原030001

出　　处：《中国矫形外科杂志》2015年第19期1774-1778,共5页Orthopedic Journal of China

基　　金：国家自然基金资助项目(编号:31340010);教育部2012高等学校博士学科专项科研基金(编号:201214171200040);山西省基础研究计划项目青年科技研究基金(编号:2013021036-3)

摘　　要：[目的]通过Meta分析评价两种假体(固定平台和移动平台)在TKA患者术后3年以上临床疗效的差异。[方法]文献检索Pubmed、Ovid、Cochrane Library、Science Direct、Springer Link数据库,严格按照纳入和排除标准筛选文献,收集TKA患者应用移动平台和固定平台的高质量的随机对照研究,提取相关数据,采用Review Manager 5.0进行数据分析。[结果]共纳入9篇随机对照研究,Meta分析结果显示:移动平台与固定平台在膝关节评分(KSS)上差异无统计学意义,RR=0.19,95%CI(1.01,1.38),P=0.74,移动平台与固定平台术后膝关节活动度(ROM)差异无统计学意义,RR=1.11,95%CI(1.0,3.21),P=0.30;两者术后并发症的发生率差异无统计学的意义,RR=1.03,95%CI(0.63,1.68),P=0.92;两种假体在膝关节置换术后3年以上患者的满意率差异无统计学意义,RR=0.80,95%CI(0.34,1.91),P=0.62。[结论]对于TKA术后3年以上的患者,移动平台相对于固定平台没有明显的优势。[Objective] To evaluate the clinical efficacy of fixed- bearing knee prostheses（ FB） or mobile- bearing knee prostheses（ MB） in total knee arthroplasty（ TKA） three years after operation. [Methods] Pubmed,Ovid,Cochrane Library,Science Direct,Springer Link database were searched. We collected high quality randomized controlled research of TKA patients,who were operated with FB or MB,on the basis of strict inclusion and exclusion criteria. The relevant data were extracted,and analyzed with Review Manager5. 0. [Results] Nine randomized controlled studies were incorporated. Meta- analysis results showed that there was no statistically significant difference on the knee score（ KSS） for patients with the MB or FB（ RR =0. 19,95% CI [1. 01,1. 01 ],P = 0. 74）. There was no statistically significant difference on Range of Motion（ ROM）（ RR = 1. 11,95% CI[1. 0,1. 0],P = 0. 30）. There was no statistically significant difference on the incidence of postoperative complications（ RR = 1. 03,95% CI [0. 63,0. 63],P = 0. 92）. And there was no statistically significant difference on the satisfaction of patients with knee arthroplasty after three years（ RR = 0. 80,95% CI [0. 34,0. 34 ],P = 0. 62）.[Conclusion] There is no obvious advantage for mobile- bearing knee prostheses over fixed- bearing knee prostheses in TKA patients more than 3 years after surgery.

关 键 词：全膝关节置换 移动平台 固定平台 META分析 

分 类 号：R687.4[医药卫生—骨科学]