手术和非手术治疗急性髌骨脱位的Meta分析  

Surgical and non-surgical treatment for acute patellar dislocation:a meta-analysis

作　　者：张券 桂钱欢 何俊[2] 苏小桃[2] 卢政好[2] 吴志良[2] 刘静男[2] ZHANG Quan;GUI Qianhuan;HE Jun;SU Xiaotao;LU Zhenghao;WU Zhiliang;LIU Jingnan(Department of Internal Medicine-Cardiovascular,the Second Affiliated Hospital,University of South China,Hengyang,Hunan 421001,China;Department of Orthopaedics,Affiliated Nanhua Hospital,University of South China,Hengyang,Hunan 421000,China)

机构地区：[1]南华大学附属第二医院心内科,湖南衡阳421001 [2]南华大学附属南华医院骨科,湖南衡阳421000

出　　处：《中国医学工程》2022年第8期18-25,共8页China Medical Engineering

基　　金：湖南省教育厅科学研究项目(18C0473)。

摘　　要：目的通过Meta分析,评估手术和非手术治疗急性髌骨脱位的临床疗效。方法在Cochrane Library,MEDLINE,PubMed,Ovid,EMBASE,万方,CNKI等数据库,检索时间从建库至2019年12月,选出有关随机对照试验文献。使用RevMan 5.3软件进行Meta分析。评价指标为髌骨再脱位率、半脱位率、再手术率、Kujala评分、患者满意度。结果纳入11篇随机对照研究,分析结果显示:短期随访和长期随访髌骨脱位复发率手术组均优于非手术组,差异有统计学意义。Kujala评分在短期随访手术组和非手术组Kujala评分差异无统计学意义,但长期随访髌骨脱位手术组Kujala评分优于非手术组,差异有统计学意义。在半脱位率、再手术率、患者满意度方面两种治疗差异无统计学意义。结论和非手术治疗髌骨脱位相比,手术治疗在再复发率有明显优势,Kujala评分长期随访结果优于非手术治疗,提示手术治疗效果良好,但在半脱位、再手术率及患者满意度方面无明显差异。【Objective】To compare the outcomes of surgical and non-surgical treatment of acute patellar dislocation by meta analysis.【Methods】Studies published from the time of database establishment through December 2019 were retrieved from the Cochrane Library,MEDLINE,PubMed,Ovid,EMBASE,Wanfang,CNKI and other databases.Relevant randomized controlled trials were selected.RevMan 5.3 software was used for the meta-analysis of evaluation indexes,including redislocation rate,subluxation rate,reoperation rate,Kujala scores,and patient satisfaction.【Results】The study cohort includes 11 randomized controlled trials.The redislocation rate of the surgical group was lower than that of the non-surgical group at both short-term and long-term follow-up.No significant difference in Kujala score was observed between surgical and non-surgical groups at short-term follow-up.Kujala scores in the surgical group were higher than those of the non-surgical group at long-term follow-up.We observed no significant difference in the rate of subluxation,reoperation,or patient satisfaction.【Conclusion】Surgical treatment of patellar dislocation has a significant advantage over non-surgical treatment with respect to redislocation rate and long-term follow-up outcomes according to Kujala score but not subluxation,reoperation rate,or patient satisfaction.

关 键 词：髌骨脱位 手术治疗 非手术治疗 META分析 

分 类 号：R687.3[医药卫生—骨科学]