髋臼盂唇撕裂患者关节镜下盂唇修复与盂唇清理疗效比较的Meta分析  

Meta-analysis of comparison of the effects after arthroscopic debridement versus re-attachment of acetabular labral tears during femoroacetabular impingement surgery

作　　者：张新涛[1] 任士友 孙礼氓 尤田[1] 江小成 张文涛[1] ZHANG Xin-tao REAr Shi-you SUN Li-meng YOU Tian JIANG Xiao-cheng ZHANG Wen-tao(Department of Sports Medicine and Rehabilitation, Peking University Shenzhen Hospital, Shenzhen, Guangdong, 510086, PRC)

机构地区：[1]北京大学深圳医院运动医学与康复科,深圳510086

出　　处：《中国骨与关节杂志》2016年第11期835-840,共6页Chinese Journal of Bone and Joint

基　　金：广东省中医药局科研课题(20131027)

摘　　要：目的分析对比关节镜下盂唇修复与盂唇清理治疗髋臼盂唇撕裂的疗效。方法检索1960年1月至2015年9月,PubMed、SpringerLink、EMBASE、the Cochrane Library、Medline、Science Direct、中国知识资源总库、万方数据库、维普数据库。收集关节镜下盂唇修复与清理治疗髋臼盂唇撕裂疗效对比的相关文献,按纳入与排除标准筛选文献并对纳入文献进行质量评价,采用Rev Man5.2软件进行分析。结果共纳入5篇文献,病例数合计为437例,所有5篇文献报道无论使用何种评分标准,术后结果均较术前有明显提升,3篇文献报道盂唇修复组术后疗效明显高于盂唇清理组,2篇文献结果显示盂唇清理组与盂唇修复组术后疗效差异无统计学意义;术后MHHS评分盂唇修复组高于盂唇清理组,术后NAHS评分两组差异无统计学意义(P<0.0001);两组手术失败率和再手术率差异无统计学意义(P=0.11,P=0.15);术后疗效优良率盂唇修复组高于盂唇清理组(P=0.007)。结论关节镜下盂唇修复与盂唇清理治疗髋臼撞击症相关的盂唇撕裂,术后疗效均较术前有明显提高;MHHS评分和术后疗效优良率关节镜下盂唇修复优于盂唇清理;手术失败率和NAHS评分两种术式差异无统计学意义。Objective To evaluate the effects of arthroscopic debridement versus re-attachment of acetabular labral tears during femoroacetabular impingement surgery. Methods Eligible studies were identified from electronic databases including PubMed, SpringerLink, EMBASE, the Cochrane Library, Medline, Science Direct, CNKI, WanFang Data and VIP from January 1960 to September 2015. We screened the retrieved literatures about comparison of the effects after arthroscopic debridement versus re-attachment of acetabular labral tears during femoroacetabular impingement surgery according to the inclusion and exclusion criteria and performed a meta-analysis with the software RevMan 5.2 after identification of the relevant data. Results Five studies met our inclusion criteria, with 437 cases in total. The outcomes got improved for the patients undergoing the treatment in all the 5 studies, regardless of surgical approach or evaluation standard. Statistically significant differences in clinical outcomes were observed in 3 out of 5 studies between the patients undergoing labral refixation and the patients undergoing labral debridement. The differences in the other 2 studies were not statistically significant. The postoperative modified Harris hip score（ MHHS） was higher in refixation group than that in debridement group. No statistically significant differences were found in the postoperative non-arthritic hip score（ NAHS） between the 2 groups（ P〈0.0001）. There were no statistically significant differences in operation failure rate and reoperation failure rate between the 2 groups（ P = 0.11, P = 0.15）. The postoperative good-to-excellent rate was higher in refixation group than that in debridement group（ P = 0.007）. Conclusions Arthroscopic re-attachment of acetabular labral tears during femoroacetabular impingement surgery results in significantly higher MHHS score and higher good-to-excellent rate when compared with arthroscopic debridement. However, there are no statistically significant differences in the impr

关 键 词：股骨髋臼撞击症 关节镜 修复外科手术 矫形外科手术 META分析 

分 类 号：R687.4[医药卫生—骨科学]