CAJ | 학술논문

目的评价高交联聚乙烯内衬较传统聚乙烯内衬在全髋关节置换术(total hiparthoplasty,THA)中是否具有优势. 方法计算机检索数据库MEDLINE、PubMed、EMBASE、Cochrane图书馆、中国生物医学光盘数据库、中国生物医学文献数据库和维普中文科技期刊数据库中关于高交联和传统聚乙烯内衬在THA的临床随机对照研究(randomized controlled trials,RCTs),并查阅所有检出文献和相关综述的参考文献作为补充资料,截止到2012年4月.采用RevMan5.1软件进行统计分析,高交联组与传统组磨损情况采用均数差评价,骨溶解和翻修手术的发生率采用优势比评价. 结果 Meta分析结果显示,与对照组相比高交联聚乙烯内衬可以明显降低患者THA术后二维线性磨损率[均数差(mean difference,MD)=-0.08,95％可信区间(confidenceinterval,CI)(-0.1,0.06),P＜0.05]、三维线性磨损率[MD=-0.15,95％ CI(-0.22,0.08),P＜o.05]、容积磨损率[MD=-53.03,95％ CI(-84.39,-21.67),P＜0.05]和总磨损量[MD=-0.19,95％ CI(-0.23,-0.15),P＜0.05],明显减少骨溶解的发生率[比值比(odds ratio,OR)=0.23,95％ CI(0.13,0.39),P＜0.05],蠕变量和翻修手术的发生率差异无统计学意义. 结论高交联聚乙烯内衬对于初次THA可以明显减少磨损和骨溶解的发生.限于纳入文献的数量和质量,Meta分析结果尚有待于更多的高质量大样本RCTs的长期随访予以证实.
목적 평개고교련취을희내츤교전통취을희내츤재전관관절치환술(total hiparthoplasty,THA)중시부구유우세. 방법 계산궤검색수거고MEDLINE、PubMed、EMBASE、Cochrane도서관、중국생물의학광반수거고、중국생물의학문헌수거고화유보중문과기기간수거고중관우고교련화전통취을희내츤재THA적림상수궤대조연구(randomized controlled trials,RCTs),병사열소유검출문헌화상관종술적삼고문헌작위보충자료,절지도2012년4월.채용RevMan5.1연건진행통계분석,고교련조여전통조마손정황채용균수차평개,골용해화번수수술적발생솔채용우세비평개. 결과 Meta분석결과현시,여대조조상비고교련취을희내츤가이명현강저환자THA술후이유선성마손솔[균수차(mean difference,MD)=-0.08,95％가신구간(confidenceinterval,CI)(-0.1,0.06),P＜0.05]、삼유선성마손솔[MD=-0.15,95％ CI(-0.22,0.08),P＜o.05]、용적마손솔[MD=-53.03,95％ CI(-84.39,-21.67),P＜0.05]화총마손량[MD=-0.19,95％ CI(-0.23,-0.15),P＜0.05],명현감소골용해적발생솔[비치비(odds ratio,OR)=0.23,95％ CI(0.13,0.39),P＜0.05],연변량화번수수술적발생솔차이무통계학의의. 결론 고교련취을희내츤대우초차THA가이명현감소마손화골용해적발생.한우납입문헌적수량화질량,Meta분석결과상유대우경다적고질량대양본RCTs적장기수방여이증실.
Objective To assess whether highly cross-linked polyethylene liners are superior to conventional polyethylene liners in total hip arthroplasty (THA).Methods Randomized controlled trials (RCTs) of highly cross-linked and conventional polyethylene liners in THA were retrieved from MEDLINE,PubMed,EMBASE,Cochrane Central,CBMdisc,CBM,and VIP.Until April 2012,reference lists of the included articles and related reviews were manually searched as supplements.Meta analysis was performed with RevMan 5.1.Mean difference (MD) was used to assess the linear wear rate in highly cross-linked group versus conventional group.Odds ratio (OR) was used to estimate the osteolysis and revision incidence in the two groups.Results Meta analysis indicated that the two-dimensional linear wear rate [MD =-0.08,95％ CI (-0.1,0.06),P ＜ 0.05],three-dimensional linear wear rate [MD=-0.15,95％CI (-0.22,0.08),P＜0.05],volumetric wear rate [MD=-53.03,95％ CI (-84.39,-21.67,P＜0.05],total linear wear [MD=-0.19,95％CI (-0.23,-0.15),P＜0.05],and osteolysis incidence [OR =0.23,95％ C1 (0.13,0.39),P ＜ 0.05] were significantly reduced in highly cross-linked group than in conventional group.There were no statistical differences between the two groups concerning the creep value of the polyethylene liners and revision incidence.Conclusions Highly cross-linked polyethylene liners for primary THA present a low incidence of wear and osteolysis.As the number and quality of the included studies are limited,a long-term follow-up of more large-sample and high-quality RCTs are needed to evidence the outcome.