中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2013年
17期
3132-3139
,共8页
陈跃平%陈亮%高辉%罗东方%尹庆水
陳躍平%陳亮%高輝%囉東方%尹慶水
진약평%진량%고휘%라동방%윤경수
骨关节植入物%骨与关节循证医学%关节成形术%关节置换%骨水泥型假体%非骨水泥型假体%假体%骨水泥%翻修率%异位骨化%稳定性%系统评价
骨關節植入物%骨與關節循證醫學%關節成形術%關節置換%骨水泥型假體%非骨水泥型假體%假體%骨水泥%翻脩率%異位骨化%穩定性%繫統評價
골관절식입물%골여관절순증의학%관절성형술%관절치환%골수니형가체%비골수니형가체%가체%골수니%번수솔%이위골화%은정성%계통평개
bone and joint implants%evidence-based medicine of bone and joint implants%arthroplasty%joint replacement%bone cement prosthesis%non-cement prosthesis%prosthesis%bone cement%overhaul rate%ectopic ossification%stability%systematic evaluation
背景:国外研究调查显示,在全膝关节置换中有95.2%采用骨水泥进行假体固定,但是也有专家学者认为使用骨水泥固定假体风险高.
目的:应用Cochrane系统评价的方法评价膝关节置换中骨水泥型与非骨水泥型假体置换的效果差异.方法:检索Medline(1996年1月至2011年8月)、Embase(1980年1月至2011年8月)、Cochranelibrary (2011年8月)、中国生物医学文献数据库(CBM,1990年1月至2011年8月)及相关参考文献,收集骨水泥型和非骨水泥型假体全膝关节置换的随机对照试验,采用Cochrane的方法学评价文献质量,应用RevMan5.1.2进行Meta分析.比较骨水泥型和非骨水泥型假体在术后生存率、稳定性、相关并发症、翻修率、异位骨化的差异.并使用GRADEpro version3.2.2软件对纳入研究进行证据评级.
结果与结论:纳入8个随机对照试验,共1381例患者,实验组(骨水泥组)676例,对照组(非骨水泥组)705例.4个研究比较了骨水泥组和非骨水泥组假体置换后≤5年组的膝关节生存率,两组差异有显著性意义,说明置换后≤5年骨水泥组生存率高.4个研究比较了置换后>5年组膝关节生存率,两组差异有显著性意义,说明置换后>5年组骨水泥假体组生存率高.3个研究在不同随访时间比较了置换后假体稳定性,结果显示两组间在假体稳定性上差异无显著性.4个研究在不同随访时间比较了置换后假体相关的并发症,两组间在假体相关并发症上比较差异无显著性意义.5个研究在不同随访时间比较了置换后翻修率,两组间在假体翻修率上差异无显著性意义.3个研究在不同随访时间比较了置换后假体异位骨化,两组间在置换后假体异位骨化上差异无显著性意义.两组置换后疗效均较术前明显提高,组间比较的Meta 分析结果显示,不论是≤5年组还是>5年组,均是骨水泥型假体生存率均高于非骨水泥型假体生存率,两组在稳定性、相关并发症、翻修率、异位骨化等方面差异均无显著性意义(P>0.05).
揹景:國外研究調查顯示,在全膝關節置換中有95.2%採用骨水泥進行假體固定,但是也有專傢學者認為使用骨水泥固定假體風險高.
目的:應用Cochrane繫統評價的方法評價膝關節置換中骨水泥型與非骨水泥型假體置換的效果差異.方法:檢索Medline(1996年1月至2011年8月)、Embase(1980年1月至2011年8月)、Cochranelibrary (2011年8月)、中國生物醫學文獻數據庫(CBM,1990年1月至2011年8月)及相關參攷文獻,收集骨水泥型和非骨水泥型假體全膝關節置換的隨機對照試驗,採用Cochrane的方法學評價文獻質量,應用RevMan5.1.2進行Meta分析.比較骨水泥型和非骨水泥型假體在術後生存率、穩定性、相關併髮癥、翻脩率、異位骨化的差異.併使用GRADEpro version3.2.2軟件對納入研究進行證據評級.
結果與結論:納入8箇隨機對照試驗,共1381例患者,實驗組(骨水泥組)676例,對照組(非骨水泥組)705例.4箇研究比較瞭骨水泥組和非骨水泥組假體置換後≤5年組的膝關節生存率,兩組差異有顯著性意義,說明置換後≤5年骨水泥組生存率高.4箇研究比較瞭置換後>5年組膝關節生存率,兩組差異有顯著性意義,說明置換後>5年組骨水泥假體組生存率高.3箇研究在不同隨訪時間比較瞭置換後假體穩定性,結果顯示兩組間在假體穩定性上差異無顯著性.4箇研究在不同隨訪時間比較瞭置換後假體相關的併髮癥,兩組間在假體相關併髮癥上比較差異無顯著性意義.5箇研究在不同隨訪時間比較瞭置換後翻脩率,兩組間在假體翻脩率上差異無顯著性意義.3箇研究在不同隨訪時間比較瞭置換後假體異位骨化,兩組間在置換後假體異位骨化上差異無顯著性意義.兩組置換後療效均較術前明顯提高,組間比較的Meta 分析結果顯示,不論是≤5年組還是>5年組,均是骨水泥型假體生存率均高于非骨水泥型假體生存率,兩組在穩定性、相關併髮癥、翻脩率、異位骨化等方麵差異均無顯著性意義(P>0.05).
배경:국외연구조사현시,재전슬관절치환중유95.2%채용골수니진행가체고정,단시야유전가학자인위사용골수니고정가체풍험고.
목적:응용Cochrane계통평개적방법평개슬관절치환중골수니형여비골수니형가체치환적효과차이.방법:검색Medline(1996년1월지2011년8월)、Embase(1980년1월지2011년8월)、Cochranelibrary (2011년8월)、중국생물의학문헌수거고(CBM,1990년1월지2011년8월)급상관삼고문헌,수집골수니형화비골수니형가체전슬관절치환적수궤대조시험,채용Cochrane적방법학평개문헌질량,응용RevMan5.1.2진행Meta분석.비교골수니형화비골수니형가체재술후생존솔、은정성、상관병발증、번수솔、이위골화적차이.병사용GRADEpro version3.2.2연건대납입연구진행증거평급.
결과여결론:납입8개수궤대조시험,공1381례환자,실험조(골수니조)676례,대조조(비골수니조)705례.4개연구비교료골수니조화비골수니조가체치환후≤5년조적슬관절생존솔,량조차이유현저성의의,설명치환후≤5년골수니조생존솔고.4개연구비교료치환후>5년조슬관절생존솔,량조차이유현저성의의,설명치환후>5년조골수니가체조생존솔고.3개연구재불동수방시간비교료치환후가체은정성,결과현시량조간재가체은정성상차이무현저성.4개연구재불동수방시간비교료치환후가체상관적병발증,량조간재가체상관병발증상비교차이무현저성의의.5개연구재불동수방시간비교료치환후번수솔,량조간재가체번수솔상차이무현저성의의.3개연구재불동수방시간비교료치환후가체이위골화,량조간재치환후가체이위골화상차이무현저성의의.량조치환후료효균교술전명현제고,조간비교적Meta 분석결과현시,불론시≤5년조환시>5년조,균시골수니형가체생존솔균고우비골수니형가체생존솔,량조재은정성、상관병발증、번수솔、이위골화등방면차이균무현저성의의(P>0.05).
@@@@BACKGROUND:The foreign researches have shown that, the bone cement prosthesis replacement accounted for 95.2%during total knee arthroplasty, but some experts believe that the use of bone cement for prosthesis fixation has high risk. @@@@OBJECTIVE:To assess the effect difference of bone cement prosthesis and non-cement prosthesis replacement in total knee arthroplasty based on Cochrane system. @@@@METHODS:The Medline database (from January 1996 to August 2011), Embase database (from January 1980 to August 2011), Cochranelibrary (August 2011), CBM database (from January 1990 to August 2011) and some other references were searched for the randomized control ed trials on bone cement prosthesis and non-cement prosthesis replacement in total knee arthroplasty. The quality of the included studies was assessed by Cochrane. RevMan 5.1.2 software was used for Meta-analysis. The differences of postoperative survival rate, stability, and related complications, revision rate and ectopic ossification of bone cement prosthesis and non-cement prosthesis were compared. CRADEpro version 3.2.2 software was used for evidence rating. @@@@RESULTS AND CONCLUSION:Total y 1 381 cases form eight randomized control ed trials were involved. The cases were divided into the experimental group (bone cement group) and the control group (non-cement group), 676 cases in the experimental group and 705 cases in the control group. Four studies compared the knee survival rate in the less or equaled 5 years postoperative group, and the difference between two groups was significant, it il ustrated that survival rate was higher in the bone cement group. Four studies compared knee survival rate in more than 5 years postoperative group, and the difference between two groups was significant, it il ustrated that survival rate was higher in the non-cement group. Three studies compared the stability of postoperative prosthesis in different fol ow-up times in two groups and showed that there was no significant difference in the stability between two groups. Four studies compared the related complication of postoperative prosthesis in two groups in different fol ow-up times and showed that there was no significant difference in related complications between two groups. Five studies compared overhaul rates of postoperative prosthesis in two grups in different fol ow-up times and showed that there was no significant difference between two groups. Three studies compared ectopic ossification of postoperative prosthesis in two groups in different fol ow-up times and showed that there was no significant difference between two groups. The curative effect after operation in two groups was improved. The Meta-analysis results compared between the greater or less 5 years groups showed that survival rate of bone cement prosthesis was higher than that of non-cement prosthesis, and there was no significant difference in stability, related complications and overhaul rates, as wel as ectopic ossification between two groups (P>0.05).
