陶瓷-陶瓷界面和陶瓷-聚乙烯界面在全髋关节置换中疗效和安全性的Meta分析

发布时间：2018-07-04 23:57

本文选题：关节成形术 + 置换　；参考：《中国组织工程研究》2016年04期

【摘要】：背景:陶瓷-陶瓷界面因低磨损而被重视,但其也伴随着异响和破裂的风险。因此目前对陶瓷-陶瓷界面和陶瓷-聚乙烯界面在全髋关节置换中的应用仍存在较多争议。目的:通过Meta分析评价陶瓷-陶瓷界面和陶瓷-聚乙烯界面在全髋关节置换中的疗效和安全性。方法:计算机检索Pub Med/Medline、Embase、Web of Science、Cochrane协作网数据库、中国生物医学文献数据库(CBMdisc)和中文期刊全文数据库(CNKI)。全面收集2015年1月前发表的比较陶瓷-陶瓷界面和陶瓷-聚乙烯界面全髋关节置换疗效和安全性的随机对照试验,并追溯纳入研究的参考文献。严格按照纳入与排除标准筛选文献、提取资料并进行质量评价,采用Rev Man 5.2进行Meta分析。结果与结论:共9个临床随机对照试验纳入研究,其中陶瓷-陶瓷界面人工关节1 231髋,陶瓷-聚乙烯界面人工关节932髋。Meta分析结果发现,陶瓷-陶瓷和陶瓷-聚乙烯人工关节均能明显改善关节功能;陶瓷-陶瓷人工关节有着较高的术中、术后假体破裂率和异响发生率,陶瓷-聚乙烯人工关节则假体磨损速度更快;但在短-中期随访中,关节脱位、骨溶解、假体松动等置换相关并发症和各原因导致的假体翻修率在两组间差异并无显著性意义。提示陶瓷-陶瓷和陶瓷-聚乙烯全髋关节假体的修复效果和安全性在短-中期随访中并无明显差异,但其二者远期效果仍有待观察。
[Abstract]:Background: ceramic-ceramic interfaces are valued for low wear, but they are also associated with the risk of abnormal noise and rupture. Therefore, the application of ceramic-ceramic interface and ceramic-polyethylene interface in total hip replacement is still controversial. Objective: to evaluate the efficacy and safety of ceramic-ceramic interface and ceramic-polyethylene interface in total hip arthroplasty by meta-analysis. Methods: the databases of Pub Med/ Medline / Embase Web of Science Cochrane collaboration, Chinese Biomedical Literature Database (CBMdisc) and Chinese Journal Full-text Database (CNKI) were searched. The randomized controlled trials published before January 2015 to compare the efficacy and safety of total hip replacement between ceramic and polyethylene interfaces were collected and reviewed retrospectively. The literature was screened according to the inclusion and exclusion criteria strictly, the data were extracted and the quality was evaluated. Rev Man 5.2 was used for meta-analysis. Results and conclusion: a total of 9 randomized controlled trials were conducted. The results of meta analysis showed that there were 1 231 artificial joints at the ceramic to ceramic interface and 932 hips on the ceramic-polyethylene interface. Ceramic-ceramic and ceramic-polyethylene artificial joints can obviously improve the function of joints, ceramic and ceramic artificial joints have higher rate of prosthesis rupture and abnormal noise after operation. The wear rate of prosthesis was faster than that of ceramic polyethylene artificial joint, but there was no significant difference between the two groups in the complications of dislocation, osteolysis and loosening of prosthesis, and the revision rate of prosthesis caused by various reasons. The results suggest that there is no significant difference in the efficacy and safety of ceramic-ceramic and ceramic-polyethylene total hip prostheses in short-and medium-term follow-up. However, the long-term effects of these two prostheses remain to be observed.
【作者单位】：中山大学附属第一医院关节外科;中山大学医学院;
【分类号】：R687.4;R318.08

【共引文献】