全膝关节置换术中运动对线和机械对线的比较：随机对照临床试验的荟萃分析,Orthopaedic Surgery

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全膝关节置换术中运动对线和机械对线的比较：随机对照临床试验的荟萃分析
Orthopaedic Surgery ( IF 1.8 ) Pub Date : 2020-10-25 , DOI: 10.1111/os.12826
Zhi-Xiang Gao ₁ , Neng-Ji Long ₁ , Shao-Yun Zhang ₁ , Wei Yu ₁ , Yi-Xin Dai ₁ , Cong Xiao ₁

Affiliation

本研究的目的是评估在全膝关节置换术 (TKA) 后的短期内，与机械对线 (MA) 相比，运动对线 (KA) 是否能改善膝关节功能或临床结果。我们从 PubMed、EMBASE、Google、Web of Science、Cochrane Library 和其他数据库中检索了 2020 年 1 月之前发表的随机对照试验的文献。观察标记包括“西安大略和麦克马斯特大学 (WOMAC) 骨关节炎指数”、“膝关节社会评分 (KSS)”、“牛津膝关节评分 (OKS)”、“膝关节社会综合评分 (KSS)”、“膝关节损伤和骨关节炎结果评分 (KOOS)、“欧洲生活质量测量 5 域 5 级 (EQ-5D-5L)”、运动范围 (ROM)、下肢对齐、韧带松解和并发症。该研究共纳入了 11 项随机对照试验研究。随访6~24个月，KA-TKA组WOMAC评分、综合KSS、KSS、膝关节功能评分、膝关节屈曲范围均优于MA-TKA组，但无明显差异。 EQ-5D-5L、KOOS、KOOS（症状、疼痛、ADL、运动和生活质量）、并发症、膝关节伸展范围、髋-膝-踝 (HKA) 角、胫骨假体倾斜角、外侧远端的差异MA-TKA 组与 MA-TKA 组之间的股骨角（LDFA）或胫骨近端内侧角（MPTA）角（P > 0.05）。我们的荟萃分析显示，MA-TKA 组的韧带松解发生率高于 KA-TKA 组。该荟萃分析表明，在短期随访中，KA-TKA 组的临床结果和膝关节屈曲范围优于 MA-TKA 组。

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Comparison of Kinematic Alignment and Mechanical Alignment in Total Knee Arthroplasty: A Meta‐analysis of Randomized Controlled Clinical Trials

The aim of this study was to estimate whether kinematic alignment (KA) improves knee function or clinical outcomes compared with mechanical alignment (MA) in the short term after total knee arthroplasty (TKA). We searched the literature for randomized controlled trials published before January 2020 from PubMed, EMBASE, Google, Web of Science, Cochrane Library, and other databases. The observation markers included “The Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index,” “Knee Society Score (KSS),” “Oxford Knee Score (OKS),” “combined Knee Society Score (KSS),” “Knee injury and Osteoarthritis Outcome Score (KOOS),” “European Quality of Life Measure‐5 Domain‐5‐Level (EQ‐5D‐5L),” range of motion (ROM), lower limb alignment, ligament release, and complications. A total of 11 randomized controlled trial studies were included in the study. During the follow‐up of 6–24 months, the KA‐TKA group was superior to the MA‐TKA group in terms of WOMAC scores, combined KSS, KSS, knee function scores, and knee range of flexion, but there was no significant difference in EQ‐5D‐5L, KOOS, KOOS (symptoms, pain, ADL, sports, and quality of life), complications, knee range of extension, hip‐knee‐ankle (HKA) angle, tibial component slope angle, lateral distal femoral angle (LDFA) or medial proximal tibial angle (MPTA) angle between the MA‐TKA group and the MA‐TKA group (P > 0.05). Our meta‐analysis revealed that the incidence of ligament release in the MA‐TKA group was higher than that in the KA‐TKA group. This meta‐analysis shows that the KA‐TKA group had better clinical outcomes and knee range of flexion than the MA‐TKA group at short‐term follow‐up.

更新日期：2020-12-28

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