中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (22): 4044-4048.doi: 10.3969/j.issn.1673-8225.2012.22.013

• 骨与关节循证医学 evidence-based medicine of the bone and joint • 上一篇    下一篇

微创切口和传统切口全髋关节置换临床疗效的系统评价★

刘  云，肖增明，廖世杰，刘会江   

  1. 广西医科大学第一附属医院脊柱骨病科，广西壮族自治区南宁市 530021
     
  • 收稿日期:2011-12-08 修回日期:2012-02-10 出版日期:2012-05-27 发布日期:2012-05-27
  • 通讯作者: 肖增明，教授，广西医科大学第一附属医院脊柱骨病外科，广西壮族自治区南宁市 530021 xiaozengming@sina.com
  • 作者简介:刘云★，男，1984年生，广西壮族自治区玉林市人，广西医科大学在读硕士，主要从事脊柱肿瘤的临床研究。Liuyun200450250@sina.com

Clinical efficacy of minimal incision and conventional incision for total hip arthroplasty: A systematic Meta-analysis

Liu Yun, Xiao Zeng-ming, Liao Shi-jie, Liu Hui-jiang   

  1. Department of Orthopedic and Spinal Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning  530021, Guangxi Zhuang Autonomous Region, China
  • Received:2011-12-08 Revised:2012-02-10 Online:2012-05-27 Published:2012-05-27
  • Contact: Liu Yun★, Studying for master’s degree, Department of Orthopedic and Spinal Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China Liuyun200450250@sina.com
  • About author:Liu Yun★, Studying for master’s degree, Department of Orthopedic and Spinal Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China Liuyun200450250@sina.com

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摘要：

背景：目前对微创全髋关节置换的争议多集中在小切口术野有限，是否会增加股骨颈骨折、神经损伤等并发症及假体位置不良，影响手术远期疗效。
目的：采用系统评价方法比较微创切口与传统切口全髋关节置换的临床疗效及安全性。
方法：检索国内外微创切口与传统切口全髋关节置换的完全随机对照试验，严格评价纳入研究的方法学质量，并提取资料，采用RevMan5.1软件行Meta分析。
结果与结论：共纳入10个随机对照试验，1 001例患者。资料分析显示，微创切口与传统切口全髋关节置换在医源性神经损伤、髋臼杯外展角、股骨柄内翻和外翻发生率、置换后髋关节脱位率、再次手术率方面差异均无显著性意义。亚组分析表明：所有后侧入路的微创切口和传统切口全髋关节置换组在髋臼杯外展角、置换后髋关节脱位率和再次手术率方面差异无显著性意义。后外侧入路的微创切口和传统切口组置换后髋关节脱位率差异无显著性意义。表明微创切口和传统切口全髋关节置换两者疗效相当。

关键词: 全髋关节置换, 随机对照试验, 并发症, Meta分析

Abstract:

BACKGROUND: At present, the controversy on minimally incision total hip arthroplasty is mainly on the wild limitation of small incision, the occurrence of femoral neck fracture, nerve injury and poor prosthetic position as well as the impact of surgery long-term efficacy.
OBJECTIVE: To compare the efficacy and safety of minimal incision and conventional incision for total hip arthroplasty.
METHODS: We searched and collected the randomized controlled trials of minimal incision and conventional incision for total hip arthroplasty. The quality of the included studies was critically assessed and the relative data were extracted. Meta analysis was performed with the statistical software Revman 5.1.
RESULTS AND CONCLUSION: Ten randomized controlled trials and 1 001 hips were included. The results of system evaluation showed that there was no statistically significant difference in the rate of iatrogenic nerve injury, the cup abduction angle, the stem alignment (varus/valgus), the rate of hip dislocation and the rate of reoperation between minimally incision and conventional exposure for total hip arthroplasty. Subgroup analysis showed that there was no significant difference in the rate of cup abduction angle, the rate of hip dislocation and the rate of reoperation, and there was no significant difference of hip dislocation rate between posterolateral approach minimally incision and conventional exposure for total hip arthroplasty. The curative effect of the minimal incision and conventional exposure for total hip arthroplasty is equivalent.

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