中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (52): 9817-9822.doi: 10.3969/j.issn.1673-8225.2011.52.029

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

前交叉韧带重建中可吸收螺钉与金属螺钉两种固定方式比较的系统评价

贝  涛，赵劲民，丁晓飞，韦庆军，刘军廷   

  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
  • 收稿日期:2011-03-03 修回日期:2011-06-06 出版日期:2011-12-24 发布日期:2011-12-24
  • 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:贝涛★，男，1984年生，汉族，广西医科大学在读硕士，主要从事创伤骨科及循证医学在骨科的应用研究。 mousebeitao@163.com

Bioabsorable interference screws versus metal interference screws in anterior cruciate ligament reconstruction: A systematic review

Bei Tao, Zhao Jin-min, Ding Xiao-fei, Wei Qing-jun, Liu Jun-ting   

  1. Department of Traumatic Orthopedics and Hand Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning  530021, Guangxi Zhuang Autonomous Region, China
  • Received:2011-03-03 Revised:2011-06-06 Online:2011-12-24 Published:2011-12-24
  • Contact: Zhao Jin-min, Department of Trauma Orthopedics and Hand Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China zhaojinmin@126.com
  • About author:Bei Tao★, Studying for master’s degree, Department of Traumatic Orthopedics and Hand Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China mousebeitao@163.com

PDF

410

被引次数

9

摘要：

背景：金属螺钉固定前交叉韧带止点被认为是该手术的金标准，随着可吸收螺钉的应用，固定止点时可吸收螺钉是否优于金属螺钉还有争议。
目的：系统评价可吸收螺钉与金属螺钉在前交叉韧带重建中的作用。
方法：检索PubMed，Ovid Medline，Cochrane图书馆，Embase，中国知网(CNKI)，中国生物医学文献数据库(CBM)，手术检索相关杂志，搜集关于可吸螺钉与金属螺钉在前交叉韧带重建中比较的临床研究。按Cochrane5.0系统评价方法进行方法学质量评价，并使用RevMan5.0.23软件进行Meta分析。使用GRADE评价证据的质量。
结果与结论：共纳入12个研究，1 032例膝关节。Meta分析结果显示：KT-1000/2000测量结果，Lachman试验，轴移试验，IKDC评分，Lysholm评分，术后感染等两组相比差异无显著性意义。在可吸收螺钉组，骨隧道扩大较明显，膝关节积液较为常见。GRADE结果：6个低质量的证据，2个极低质量证据，4个中等质量的证据。使用可吸收螺钉膝获得与金属螺钉等同的临床，但由于纳入的文献质量较低及论证强度不高，随访时限较短。故需要大样本，高质量，长期随访的研究来进一步论证。

关键词: 可吸收螺钉, 金属螺钉, 前交叉韧带, 重建, 系统评价

Abstract:

BACKGROUND: Metal screws have even been regarded as the gold standard in anterior cruciate ligament reconstruction, but now it is being challenged by the application of bioabsorable screws. But there is still controversy whether bioabsorable screw is superior to metal screw. 
OBJECTIVE: To perform a systematic review of bioabsorable interference screw versus metal interference screw in anterior cruciate ligament reconstruction.                                     
METHOD: A literature searching of PubMed, Ovid Medline Cochrane Libarary, Embase, EBSCO, CNKI and CBM about bioabsorable interference screw versus metal interference screw in anterior cruciate ligament reconstruction was done. Hand searching of related journals was carried out. The quality of the eligible studies were assessed according to the Cochrane Handbook 5.0. We used RevMan5.0.23 to do Meta-analysis. The strength of evidence was assessed using GRADE profile.
RESULTS AND CONCLUSION: Eleven Randomized controlled trials and one quasi-randomized controlled trial were eligible for our study. Meta-analysis results demonstrated that there were no significant differences in KT-1000/2000 test, Lachman test, Pivot shift test, IKDC score, Lysholm score,and rate of infection. In bioabsorable interference screw group, tunnel enlargement was more common. The rate of knee effusion was slightly higher in bioabsorable interference screw group. GRADE results showed that there were 6 low quality evidences, 2 very low quality evidences and 4 moderate quality evidences. Bioabsorable screws could acquire the same efficiency compared with metal interference screw. Due to the low quality of included studies, low quality of evidence and short follow-up, further, high quality, and large sample trials are required.

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