中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (25): 4737-4740.doi: 10.3969/j.issn.1673-8225.2010.25.044

• 生物材料学术探讨 biomaterial academic discussion • 上一篇    下一篇

不同材料重建前交叉韧带腱骨愈合的系统评价

周玉坤1，彭鸿灵2   

  1. 1贵阳医学院附属医院骨科，贵州省贵阳市  550000；2四川大学华西临床医学院，四川省成都市  610041
  • 出版日期:2010-06-18 发布日期:2010-06-18
  • 作者简介:周玉坤，1965年生，副主任医师，研究方向：骨关节及创伤。 zhou.yukun@yahoo.com

Evaluation on different materials for anterior cruciate ligament reconstruction and tendon bone healing

Zhou Yu-kun1, Peng Hong-ling2   

  1. 1 Department of Orthopaedics, Affiliated Hospital of Guiyang Medical College, Guiyang   550000, Guizhou Province, China; 2 West China Medical School, Sichuan University, Chengdu   610041, Sichuan Province, China
  • Online:2010-06-18 Published:2010-06-18
  • About author:Zhou Yu-kun, Associate chief physician, Department of Orthopaedics, Affiliated Hospital of Guiyang Medical College, Guiyang 550000, Guizhou Province, China zhou.yukun@yahoo.com

PDF

467

被引次数

7

摘要：

目的：探讨自体与同种异体材料重建前交叉韧带的临床疗效及腱骨愈合的影响因素。
方法：电子检索EMbase(1980-01/2010-01)，MEDLINE(1966-01/2010-01)，中国生物医学文献数据库(CBM，1978-01/2010-01)和中文学术期刊全文数据库(CNKI)，获取相关文献。对动物实验进行归纳分析，对临床对比研究采用Review Manager4.2 软件进行分析。
结果：从41篇动物研究中选出8篇文献，结果显示各实验组腱骨愈合均取得有良好效果，重建的前交叉韧带具有更好的生物学和力学特性。从53篇临床文献中选取7篇对比研究，采用Meta分析结果显示，自体组织重建组优于同种异体组织重建组，但不具有显著性意义(P =0.05)，7篇文献实验的RR值和95%CI分别为-4.70(-10.14，0.74)，-3.00(-6.55，0.55)，-1.60(-4.81，1.61)，-1.80(-5.24，1.64)，-1.00(-3.45，1.45)，0.80(-1.85，3.45)和-0.70(-2.73，1.33)，合并后的RR值和95%CI为-1.10(-2.18，-0.01)。
结论：骨膜包被、骨形态蛋白、骨保护素、骨髓间充质干细胞、骨诱导性钙磷陶瓷、磷酸三钙等多种材料都可以促进腱骨愈合，同种异体重建前交叉韧带可以达到与自体组织相似的临床效果，值得推广。

关键词: 骨隧道, 腱骨愈合, 同种异体骨, 系统评价, 前交叉韧带

Abstract:

OBJECTIVE: To investigate the influencing factors for clinical efficacy of autologous and allogenic materials to reconstruct the anterior cruciate ligament and tendon bone healing.
METHODS: A computer search was performed on EMbase (1980-01/2010-01), MEDLINE (1966-01/2010-01), Chinese Biomedical Literature Database (1978-01/2010-01) and Chinese Academic Periodicals Full-text Database (CNKI). The animal experiments were involved, clinical comparative study was analyzed using Review Manager 4.2 software.
RESULTS: From 41 animal researches, 8 articles were selected. Results show that tendon bone healing achieved good results in all experimental groups, the reconstructed anterior cruciate ligament had better biological and mechanical properties. From 53 clinical literatures, 7 comparative studies were selected. Meta analysis results showed that, autologous tissue reconstruction was superior to allogenic tissue reconstruction, without significant difference (P = 0.05). The RR value and 95% CI of 7 articles were respectively -4.70 (-10.14, 0.74), -3.00 (-6.55, 0.55), -1.60 (-4.81, 1.61), -1.80 (-5.24, 1.64), -1.00 (-3.45, 1.45), 0.80 (-1.85, 3.45) and -0.70 (-2.73, 1.33). The combined RR values and 95% CI were -1.10 (-2.18, -0.01).
CONCLUSION: The tendon bone healing can be promoted by a variety of materials such as periosteum-coated, bone morphogenetic protein, osteoprotegerin, bone marrow mesenchymal stem cells, bone induced calcium phosphate, and calcium phosphate. Allograft anterior cruciate ligament reconstruction can achieve similar clinical effect to autologous tissue and deserve further application.

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