磁共振成像评估初次髌骨脱位导致内侧髌股韧带不同部位损伤与脱位复发风险关联的Meta分析  

Evaluation of the relationship between injury site of medial patellofemoral ligament caused by primary patellar dislocation and risk of recurrence:a meta-analysis

作　　者：王婧娟[1] 那玉岩 任逸众[2] 韩长旭[2] 张婷[2] WANG Jing-juan;NA Yu-yan;REN Yi-zhong;HAN Chang-xu;ZHANG Ting(Department of Orthopeadics,The Second Affiliated Hospital of Inner Mongolia Medical University,Hohhot,Inner Mongolia,010030,China)

机构地区：[1]内蒙古医科大学第二附属医院康复科,呼和浩特010030 [2]内蒙古医科大学第二附属医院关节镜与运动医学外科,呼和浩特010030

出　　处：《中国骨与关节杂志》2021年第11期828-833,共6页Chinese Journal of Bone and Joint

基　　金：内蒙古自治区自然科学基金(2020MS08119);内蒙古医科大学高等教育教学改革研究项目(NYJXGG2020178)。

摘　　要：目的初次髌骨脱位非手术治疗有较高的复发脱位风险。本研究旨在评估初次髌骨脱位导致内侧髌股韧带不同部位损伤与脱位复发风险。方法使用MEDLINE,Embase和Cochrane Library检索直至2020年1月的原始性研究。使用Review Manager 5.3软件汇总比较不同部位内侧髌股韧带损伤的复发脱位差异性。结果内侧髌股韧带股骨附着处损伤总体复发髌骨脱位发生率更高(股骨端vs.髌骨端vs.两端联合:37.6%vs.32.3%vs.35.8%),文献分析结果未发现三组间差异有统计学意义[股骨端vs.髌骨端RR=1.32(95%CI,0.89~1.95);P=0.17][股骨端vs.两端联合RR=1.15(95%CI,0.59~2.22);P=0.68][髌骨端vs.两端联合RR=0.94(95%CI,0.69~1.29);P=0.72]。复发脱位组股骨滑车沟关节面角度显著大于未复发脱位组[MD=3.06(95%CI,0.42~5.70);P=0.02]。结论不同部位内侧髌股韧带损伤相比较结果显示,复发髌骨脱位的风险并无差异;复发脱位组股骨滑车沟关节面角度显著大于未复发脱位组,即滑车沟越浅平,髌骨复发脱位的风险越高。Objective Non-surgical treatment of primary patellar dislocation has a high risk of recurrence.The purpose of this study is to evaluate the relationship between injury site of medial patellofemoral ligament caused by primary patellar dislocation and risk of recurrence.Methods Original studies from MEDLINE,Embase and Cochrane Library were retrieved until January 2020.Review Manager 5.3 software was used to summarize and compare the differences of redislocation risk of medial patellofemoral ligament(MPFL)injuries at different parts.Results The incidence of recurrent patellar dislocation at the femoral attachment was higher overall(femur 37.6%,patella 32.3%,femur plus patella 35.8%).Statistical differences were found among the three groups[femur vs.patella,RR=1.32(95%CI,0.89-1.95),P=0.17;femur vs.femur plus patella,RR=1.15(95%CI,0.59-2.22),P=0.68;patella vs.femur plus patella,RR=0.94(95%CI,0.69-1.29),P=0.72].Articular surface angle of the trochlear groove in the redislocation group was larger than that in the group without redislocation[MD=3.06(95%CI,0.42-5.70);P=0.02].Conclusions MPFL injury site is not related with recurrence risk.Shallower trochlear groove indicates higher risk of recurrent dislocation.

关 键 词：髌骨脱位 髌股关节 韧带 关节 磁共振成像 META分析 

分 类 号：R445.2[医药卫生—影像医学与核医学] R686.5[医药卫生—诊断学]