关节镜下前交叉韧带重建保留残端与否干预膝关节本体感觉功能恢复的Meta分析

发布时间：2018-02-28 03:22

本文关键词： 前交叉韧带本体感觉 Meta分析组织工程骨科植入物重建保留残端不保留残端　出处：《中国组织工程研究》2017年03期 　论文类型：期刊论文

【摘要】：背景:对于前交叉韧带严重损伤或断裂的患者,膝关节镜下前交叉韧带重建是目前常规手术修复方案,而对于术中前交叉韧带残端的保留问题,目前众说纷纭,其对膝关节本体感觉的影响也越来越受到人们的关注。目的:通过Meta分析比较关节镜下保留残端与不保留残端重建前交叉韧带对其本体感觉功能恢复的效果差异。方法:检索从2001至2016年关于采用关节镜下保留残端与不保留残端重建前交叉韧带的临床对照研究文献,采用Meta分析方法对采用这两种手术患者的术后膝关节被动活动感知阈值、被动角度再生试验、关节位置觉及KT 1000/2000评分、IKDC评分、Lysholm评分等进行比较。结果与结论:(1)共纳入11篇文献;(2)Meta分析结果:与重建前交叉韧带不保留残端相比,保留残端在膝关节被动活动感知阈值[OR=-0.50,95%CI(-0.74,-0.26),P0.000 1]、膝关节被动角度再生试验[OR=-0.13,95%CI(-0.26,-0.01),P=0.030.05]、Lysholm评分[OR=1.25,95%CI(0.63,2.06),P=0.000 2]、IKDC评分[OR=1.28,95%CI(0.27,2.28),P=0.01]等方面更具优势;而在膝关节关节位置觉[OR=-0.30,95%CI(-0.79,0.18),P=0.22]、KT 1000/2000评分[OR=-0.05,95%CI(-0.13,0.03),P=0.24]方面两者差异无显著性意义;(3)结果提示,重建前交叉韧带保留残端比不保留残端更有益于膝关节本体感觉的恢复,但仍需前瞻性大样本长期的随机对照试验来验证。
[Abstract]:Background: for patients with severe injury or rupture of anterior cruciate ligament, arthroscopic reconstruction of anterior cruciate ligament is currently a routine surgical repair scheme, but there are different opinions on the preservation of anterior cruciate ligament stump during operation. The effect of ACL on the proprioceptive sensation of knee joint has been paid more and more attention. Objective: to compare the effect of arthroscopic reconstruction of anterior cruciate ligament (ACL) on the recovery of proprioceptive function by Meta. Methods: from 2001 to 2016, a clinical comparative study on the reconstruction of anterior cruciate ligament (ACL) with or without stump under arthroscopy was searched. The passive motion perception threshold and passive angle regeneration test of knee joint were performed by Meta analysis. The joint position perception and the KT 1000/2000 score were compared with the KT 1000/2000 score and the Lysholm score. Results and conclusions: 11 literatures were included in the study. The results of meta analysis were as follows: compared with the reconstruction of anterior cruciate ligament without preserving the stump, the joint position perception and the KT 1000/2000 score were compared with those of the anterior cruciate ligament reconstruction. The residual ends were superior in the perception threshold of passive activity of the knee joint [OR-0.50 ~ 95CI-0.74U -0.26], the passive angle regeneration test of the knee joint [OR-0.1395CI-0.26CI-0.01CI-0.030.05] and Lysholm score [OR1.2595CI0.633.06 P0.0002] and IKDC score [OR1.2895CIT 0.272.28CIT 0.272.28P0.01]. However, there was no significant difference in the knee joint position perception [OR-0.3095 CI-0.79 ~ 0.18] KT 1000/2000 score (OR-0.05 ~ 95CI-0.130.03 ~ 0.24). The results showed that the reconstruction of anterior cruciate ligament residual was more beneficial to the recovery of the proprioceptive sensation of the knee than to the non-preservation of the residual end of the anterior cruciate ligament. But long-term randomized controlled trials with large prospective samples are still needed.
【作者单位】：新疆医科大学第一附属医院;新疆武警兵团指挥部医院;
【分类号】：R318

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