CAJ | 학술논문

背景：当今，前交叉韧带重建是修复膝关节前交叉韧带损伤的常用方法，但就重建移植物的选择问题尚存在不少争议。 　　目的：比较自体与非放射线处理的同种异体肌腱移植重建前交叉韧带临床疗效的差异。 　　方法：计算机检索 PubMed/Medline 数据库以及手工检索国内外公开发表的有关自体与非放射线处理的同种异体肌腱移植重建前交叉韧带的随机对照试验，所有文献检索截止至2014年7月12日。应用RevMan5.2软件进行数据统计分析，输入数据时采取双人核对以确保准确无误。 　　结果与结论：共纳入6项随机对照试验，累计858例受试对象，其中自体肌腱组441例，非放射线处理的同种异体肌腱组417例。荟萃分析结果显示，自体与非放射性处理的同种异体肌腱移植重建前交叉韧带的总IKDC评分[相对危险度=1.02，95%置信区间(0.99-1.06)，P=0.21]；松弛度[均数差=-0.13，95%置信区间(-0.29至-0.02)，P=0.09]；Lachman试验[相对危险度=1.04，95%置信区间(0.95-1.13)，P=0.37]；pivot shift试验[相对危险度=1.00，95%置信区间(0.95-1.05)，P=0.96]；one-leg hop试验[相对危险度=1.01，95%置信区间(0.96-1.06)，P=0.77]；Lysholm评分[均数差=-0.64，95%置信区间(-1.45-0.17)，P=0.12]；Tegner评分[均数差=0.16，95%置信区间(-0.16-0.47)， P=0.34]以及并发症发生率[相对危险度=1.42，95%置信区间(0.67-3.04)，P=0.36]的差异无显著性意义。以上结果表明，自体与非放射线处理的同种异体肌腱移植重建前交叉韧带的临床疗效并无明显差异，但鉴于此研究存在一定局限性，此结论有待更多更高质量的随机对照试验进一步证实。
배경：당금，전교차인대중건시수복슬관절전교차인대손상적상용방법，단취중건이식물적선택문제상존재불소쟁의。 　　목적：비교자체여비방사선처리적동충이체기건이식중건전교차인대림상료효적차이。 　　방법：계산궤검색 PubMed/Medline 수거고이급수공검색국내외공개발표적유관자체여비방사선처리적동충이체기건이식중건전교차인대적수궤대조시험，소유문헌검색절지지2014년7월12일。응용RevMan5.2연건진행수거통계분석，수입수거시채취쌍인핵대이학보준학무오。 　　결과여결론：공납입6항수궤대조시험，루계858례수시대상，기중자체기건조441례，비방사선처리적동충이체기건조417례。회췌분석결과현시，자체여비방사성처리적동충이체기건이식중건전교차인대적총IKDC평분[상대위험도=1.02，95%치신구간(0.99-1.06)，P=0.21]；송이도[균수차=-0.13，95%치신구간(-0.29지-0.02)，P=0.09]；Lachman시험[상대위험도=1.04，95%치신구간(0.95-1.13)，P=0.37]；pivot shift시험[상대위험도=1.00，95%치신구간(0.95-1.05)，P=0.96]；one-leg hop시험[상대위험도=1.01，95%치신구간(0.96-1.06)，P=0.77]；Lysholm평분[균수차=-0.64，95%치신구간(-1.45-0.17)，P=0.12]；Tegner평분[균수차=0.16，95%치신구간(-0.16-0.47)， P=0.34]이급병발증발생솔[상대위험도=1.42，95%치신구간(0.67-3.04)，P=0.36]적차이무현저성의의。이상결과표명，자체여비방사선처리적동충이체기건이식중건전교차인대적림상료효병무명현차이，단감우차연구존재일정국한성，차결론유대경다경고질량적수궤대조시험진일보증실。
BACKGROUND:Reconstruction of the anterior cruciate ligament has become the gold-standard treatment for an anterior cruciate ligament rupture. Despite the popularity of the procedure, there remains a considerable amount of controversies over whether an autograft or anal ograft should be used for primary anterior cruciate ligament reconstruction. OBJECTIVE:To compare the clinical outcomes of al ograft and autograft in primary anterior cruciate ligament reconstruction. METHODS:Randomized control ed trials concerning autograft versus non-irradiated al ograft for anterior cruciate ligament reconstruction were identified from the PubMed/Medline database conducted up to July 12, 2014. These studies were selected independently by two reviewers according to the inclusion and exclusion criteria. Meta-analysis was performed using Revman5.2 software. RESULTS AND CONCLUSION:A total of 6 randomized control ed trials consisting of 858 cases were included, 441 cases in autograft group and 417 cases in non-irradiated al ograft. The results of the meta-analysis indicate no significant difference between autografts and non-irradiated al ografts in overal IKDC [relative risk (RR)=1.02, 95%confidence interval (CI) (0.99 to 1.06), P=0.21], degree of laxity [mean difference (MD)=-0.13, 95%CI (-0.29 to-0.02), P=0.09], Lachman test [RR=1.04, 95%CI (0.95 to 1.13), P=0.37], pivot shift test [RR=1.00, 95%CI (0.95 to 1.05), P=0.96], one-leg hop test [RR=1.01, 95%CI (0.96 to 1.06), P=0.77], Lysholm score [MD=-0.64, 95%CI (-1.45 to 0.17), P=0.12], Tegner score [MD=0.16, 95%CI (-0.16 to 0.47), P=0.34] and rate of postoperative complications [RR=1.42, 95%CI (0.67 to 3.04), P=0.36]. Therefore, in the meta-analysis, there is no significant difference between autograft and non-irradiated al ograft in clinical outcomes. However due to the limitations of our study, further work is needed to determine this conclusion.