中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (13): 2281-2284.doi: 10.3969/j.issn.1673-8225.2010.13.001

• 骨与关节循证医学 evidence-based medicine of the bone and joint •    下一篇

旋转平台和固定平台假体进行全膝关节置换效果的系统评价

罗世兴，赵劲民，苏  伟，沙  轲，韦庆军，李晓峰   

  1. 广西医科大学第一附属医院创伤骨科手外科，广西壮族自治区南宁市  530021
  • 出版日期:2010-03-26 发布日期:2010-03-26
  • 通讯作者: 赵劲民，广西医科大学第一附属医院创伤骨科手外科，广西壮族自治区南宁市 530021 zhaojinmin@126.com
  • 作者简介:罗世兴☆，男，1978年生，广西壮族自治区合浦市人，汉族，在读博士，主治医师，主要从事关节外科研究。 luosong888aaa@hotmail.com

Mobile-bearing versus fixed-bearing in total knee arthroplasty: A systematic review

Luo Shi-xing, Zhao Jin-min, Su Wei, Sha Ke, Wei Qing-jun, Li Xiao-feng   

  1. Hand Surgery, Department of Trauma Orthopedics, First Affiliated Hospital of Guangxi Medical University, Nanning   530021, Guangxi Zhuang Autonomous Region, China
  • Online:2010-03-26 Published:2010-03-26
  • Contact: Zhao Jin-min, Hand Surgery, Department of Trauma Orthopedics, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China zhaojinmin@l26.com
  • About author:Luo Shi-xing☆, Studying for doctorate, Attending physician, Hand Surgery, Department of Trauma Orthopedics, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China luosong888aaa@hotmail.com

PDF

438

被引次数

19

摘要：

背景：目前学术界对旋转假体是否优于固定假体仍有争议。许多研究者认为旋转平台型假体优于固定平台型假体，但也有很多研究者认为两者疗效没有明显差异。
目的：比较全膝关节置换中应用旋转或固定平台型假体的临床结果，评价两类假体的疗效差异。
方法：检索Medline(1966-01/2009-11)、Embase(1980-01/2009-11)、Cochrane library(2009-11)、中国生物医学文献数据库(CBM, 1990-01/2009-11)及相关参考文献，收集比较旋转和固定型假体全膝关节置换的随机对照试验，采用Cochrane的随机方法学评价文献质量，应用RevMan5.0.18进行Meta分析。
结果与结论：纳入11个随机对照试验，共1 427膝，旋转组694膝，固定组723膝。纳入研究的方法学偏倚均较低。术后疗效均较术前明显提高，组间比较的Meta分析结果显示，两组膝关节评分、关节活动度及假体脱位率、翻修率均未发现明显的统计学差异。4例假体脱位均发生在旋转组，脱位率约为1.8%(4/217)。结果显示，目前证据未能证明旋转平台假体优于固定平台假体，需要开展更多高质量的对照试验加以证实，但无论选择何种假体均有可能获得满意的临床效果。

关键词: 全膝关节置换, 旋转平台, 固定平台, 系统评价, 医学植入物, 膝关节假体

Abstract:

BACKGROUND: The question regarding whether mobile bearing prostheses has superiority over fixed-bearing prostheses remains controversial. Although some scholars believed that mobile bearing prostheses is better than fixed-bearing prostheses, other researchers argue no differences between both implant types.
OBJECTIVE: To compare the clinical results of mobile bearing with fixed-bearing in total knee arthroplasty (TKA) and to assess the differences between two groups.
METHODS: We conducted computer-aided searches of Medline (January 1966 to November 2009), Embase (January 1980 to November 2009), Cochrane library (November 2009), Chinese Biomedical Databases (CBM, January 1990 to November 2009) with references to mobile bearing versus fixed-bearing in TKA. Randomized controlled studies on TKA between mobile bearing and fixed-bearing prostheses were collected. The methodological quality of included studies was assessed by using of assessments of risk of bias in Cochrane handbook 5.0.1. RevMan 5.0.18 software was used for Meta-analysis.
RESULTS AND CONCLUSION: A total of 11 randomized controlled trials were included with a total of 1 427 knees, 694 knees in mobile bearing and 723 knees in fixed-bearing. The bias in the studies was low. Postoperative outcomes were significantly elevated compared with preoperative outcomes. The outcomes of Meta-analysis showed that no statistical significance differences on Knee score range of motion (ROM), bearing dislocation, need for repeated surgery. But, 4 dislocation knees all occurred in four studies of mobile bearing TKA, the rate of dislocation was 1.8% (4/217). The results showed that no significant differences on clinical results and complications compared mobile bearing prosthesis with fixed-bearing prosthesis in TKA, we advise that more evidences should be needed for supporting the outcomes, and both types of prosthesis can get well results in clinical trial.

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