膝关节骨关节炎患者初次全膝关节置换术中选择髌骨置换的meta分析

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1、中华关节外科杂志(电子版)2010年8月第4卷第4期ChinJJointSurg(ElectronicEdition)，August2010，Vo1．4，No．4临床论著·膝关节骨关节炎患者初次全膝关节置换术中选择髌骨置换的Meta分析罗世兴赵劲民苏伟李晓峰【摘要】目的探讨膝关节骨关节炎(OA)进行初次全膝关节置换术(TKA)中选择髌骨置换与否的疗效，评价两种不同治疗选择的差异。方法检索Medline、Embase、Cochranelibrary、CBM，收集膝关节OA行初次TKA术中髌骨置换与否的临床对照试验，提取数据

2、分析，采用RevMan5．0．18进行Meta分析。结果纳入8个前瞻性随机对照试验，共822例手术，其中髌骨置换组373例，髌骨非置换组444例。髌骨置换与非置换组比较，前膝痛与KSS评分均无明显的统计学意义(P>0．5)，置换组的因髌股关节问题而再次手术率低于非置换组[RR=0．53，95％CI(0．29，0．96)，P：0．04]，但置换组再次手术的原因除了常见的前膝痛，还包括髌骨假体相关的并发症。结论膝关节OA的患者行初次TKA术中选择髌骨置换与否的前膝痛与KSS评分无明显的统计学意义，置换组的因髌股关节问题再次手

3、术率低于非置换缰，但置换组再次手术的复杂性大于非置换组。【关键词】骨关节炎；关节成形术，置换，膝；髌骨；Meta分析Patellarresurfacingornon-resurfacingintotalkneearthroplastyforosteoarthritis：ameta-analysisLUOShi—xing，ZHAOfin—rain，SUWei，L1Xiaong．DepartmentofTraumaOrthopedics，FirstAffiliatedHospitalofGuangxiMedicalUnive

4、rsity，Nanning530021，ChinaCorrespondingauthor：ZHAOfin—rain，E—mail：zhaojinmin@126．com【Abstract】objectiveTocomparetheclinicaleffectsbetweenpatellarresurfacingandnon—resurfacingintotalkneearthroplasty(TKA)forosteoarthritis(OA)．MethodsThedatabasesofCochranelibrary，Med

5、line，EmbaseandChineseBiomedicalDatabasesweresearchedonline．Allthetrialscomparingpatellarresurfacingwithnon—resurfacinginTKAforOAwereincluded．Methodologyqualitywasassessedandthedataofthecomplicationswithinbothgroupswasextracted．TheRevman5．0．18softwarepackagewasuse

6、dfordata—analysis．Themajorcausesofthereoperationsinthepatellarresurfacinggroupincludingpaininanteriorkneeandthecomplicationsrelatedtopatellarcomponentfailure．ResultsEighttrialswith822kneeswereincluded(373patellarresurfacing／444patellarnon—resurfacing)．TheMeta—ana

7、lysisshowedthattherewerenosignificantdifferencesinKneeSocietyClinicalScoresandanteriorkneepainbetweenthetwogroupsinatleasttwoyearsfollow—up(P>0．5)，butreoperationrateforpatellofemoralproblemsofthenon—resurfacinggroupwassignificantlylower[RR=0．53，95％C1(0．29，0．96)，P

8、：0．04]．ConclusionsOurresultsindicatethatpatellarresurfacingwouldreducetheriskofreoperationaftertotalkneearthroplastyforOA，butitseemsthatthebenefitsarelimitedon