CAJ | 학술논문

目的：系统评价经小切口股内侧肌入路行全膝关节置换术的疗效及安全行。方法使用计算机检索Cochrane图书馆、PubMed和CBM等数据库，并行手工检索，全面搜索关于经小切口股内侧肌入路及髌骨旁入路行全膝关节置换术的临床对比研究。由两名评价员独立筛选及纳入研究、提取数据资料及行方法学质量评估，采用Cochrane协作网提供的RevMan5．2软件进行Meta分析。结果共纳入符合本研究的试验文献11篇，其中小切口股内侧肌入路组395例，传统髌骨旁入路组372例。两组在术后并发症发生率、出血量、术后6周及3个月KSS临床与功能评分、手术时间、假体力线等方面未发现统计学差异。术后膝关节屈曲活动度、切口长度等方面，小切口股内侧肌入路组表现优于传统髌骨旁入路组。结论现有证据表明，小切口股内侧肌入路同髌骨旁入路对比，在并发症发生率、手术时间、假体力线、术后KSS评分、出血量以及术后关节屈曲活动度方面效果相似。但小切口股内侧肌入路行全膝关节置换切口更小，且能获得更快的膝关节功能恢复速度。受纳入研究质量的限制，上述结果还有待开展更多高质量的临床试验来进一步证实。
목적：계통평개경소절구고내측기입로행전슬관절치환술적료효급안전행。방법사용계산궤검색Cochrane도서관、PubMed화CBM등수거고，병행수공검색，전면수색관우경소절구고내측기입로급빈골방입로행전슬관절치환술적림상대비연구。유량명평개원독립사선급납입연구、제취수거자료급행방법학질량평고，채용Cochrane협작망제공적RevMan5．2연건진행Meta분석。결과공납입부합본연구적시험문헌11편，기중소절구고내측기입로조395례，전통빈골방입로조372례。량조재술후병발증발생솔、출혈량、술후6주급3개월KSS림상여공능평분、수술시간、가체력선등방면미발현통계학차이。술후슬관절굴곡활동도、절구장도등방면，소절구고내측기입로조표현우우전통빈골방입로조。결론현유증거표명，소절구고내측기입로동빈골방입로대비，재병발증발생솔、수술시간、가체력선、술후KSS평분、출혈량이급술후관절굴곡활동도방면효과상사。단소절구고내측기입로행전슬관절치환절구경소，차능획득경쾌적슬관절공능회복속도。수납입연구질량적한제，상술결과환유대개전경다고질량적림상시험래진일보증실。
Objective To evaluate the efficacy and safety of the mini-midvastus ( Mini-MV ) approach in the total knee arthroplasty (TKA).Methods The Cochrane Library, PubMed, SINO,and CBM were searched to identify the clinical trials comparing the mini-midvastus approach with the medial parapatellar ( SMP) approach in TKA .The quality of the included studies was critically assessed by two assessors independently and the data analyses were performed by the Cochrane Collaboration 's RevMan 5.2.Results 11 studies were included, involving six randomized controlled trials (RCTs), one quasi-RCTs and four non-RCTs.The Mini-MV TKA group consisted of 395 knees, and the SMP TKA group consisted of 372 knees.All trails were identified as meeting all the eligibility criteria .The meta-analysis did not find significant differences in the postoperative complications , blood loss, postoperative Knee Society objective scores ,functional Knee Society scores , operative time and component alignments .There were advantages in the flexion range of knees and the incision length for the Mini -MV approach to SMP approach.Conclusion Based on the current evidence , the Mini-MV approach for total knee arthroplasty is as safe and effective as the medial parapatellar approach , but smaller incision leads to faster functional recovery of the knees .Due to the poor quality of the included trials , more high-quality RCTs are needed .