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开放性楔形胫骨高位截骨术中植骨与未植骨的Meta分析
Open wedge high tibial osteotomy with and without bone graft: A Meta-analysis
  
DOI:
中文关键词:  胫骨高位截骨  植骨  未植骨  Meta分析
英文关键词:High tibia osteotomy(HTO)  Bone graft  Without bone graft  Meta analysis
基金项目:
作者单位
罗旺林 许国星 冯志 韩爽 戴国强 杨传军*  
通讯作者:罗旺林 许国星 冯志 韩爽 戴国强 杨传军*    
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中文摘要:
      目的 通过Meta分析系统评价开放性楔形胫骨高位截骨术(OWHTO)治疗术中植骨与未植骨的疗效。方法 通过计算机检索建库至2021年4月PubMed、Cochrane Library、Embase、中国知网、万方数据库,查找所有比较开放性楔形胫骨高位截骨术中植骨与未植骨的临床对照研究,根据纳入标准及排除标准进行文献筛选、质量评价和数据提取后,应用Revman 5.4软件对各项评价指标进行Meta分析。结果 共纳入10篇文献,共581例膝关节病例,其中279 例植骨,302 例未植骨。Meta 分析结果显示:植骨与未植骨相比,骨性愈合时间[MD=-0.2,95%CI(-0.26,-0.14),P<0.001]、术后FTA[MD=0.7,95%CI(0.23,1.17),P=0.004]比较,差异有统计学意义(P<0.05);但术后3个月骨性愈合率、术后矫正丢失角度、术后KSS膝关节评分、术后KSS功能评分、术后膝关节Lysholm评分、术后IKDC评分、术后并发症比较,差异均无统计学意义。结论 两组患者均获得良好的术后功能及疗效,开放性楔形胫骨高位截骨术植骨组的骨性愈合较快,但术后3个月的骨性愈合率无差异,所以对于术中截骨后撑开高度较小时,可以考虑不植骨。
英文摘要:
      Objective A systematic review of the efficacy of opening wedge high tibial osteotomy (OWHTO) with intraoperative bone graft versus no bone graft by meta-analysis was conducted. Methods Through computer search of PubMed, Cochrane Library, Embase, CNKI, Wanfang database from the establishment of the database to April 2021, all clinical comparative studies of with and without bone graft in open wedge high tibial osteotomy were searched. After literature screening, quality evaluation and data extraction were carried out according to the inclusion criteria and exclusion criteria, and the Revman 5.4 software was used to conduct a Meta analysis of each evaluation index. Results A total of 10 articles were included, including 581 knee joint cases, including 279 cases with bone grafts and 302 cases without bone grafts. Meta-analysis results showed that: Compared with non-grafted bone, the bone healing time [MD=-0.2, 95%CI(-0.26, -0.14), P<0.001], postoperative FTA [MD=0.7, 95%CI(0.23, 1.17), P=0.004] had a statistical differences, but the rate of bone healing at 3 months postoperatively, postoperative correction loss angle, postoperative KSSK, postoperative KSSF, postoperative Lysholm Knee Score, postoperative IKDC Score, and postoperative complications had no statistical difference. Conclusion Both groups of patients achieved good postoperative function and curative effect. The bone healing in the open wedge-shaped high tibial osteotomy and bone grafting group was faster, but there was no difference in the bone healing rate 3 months after operation. Therefore, if the distraction height after osteotomy was small, no bone grafting could be considered.
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