目的:通过Meta分析系统评价自体骨移植和骨替代物治疗胫骨平台骨折的临床疗效。方法:计算机检索2005年1月至2022年8月PubMed、Web of Science、中国知网、万方等数据库已发表的关于自体骨移植和骨替代物治疗胫骨平台骨折的病例对照研究文献。根据纳排标准进行文献筛选及数据提取，对入选的随机对照研究(randomized controlled trial，RCT)采用Cochrane手册中的干预性Meta分析标准进行质量评价。采用RevMan 5。3软件对两种方法的关节凹陷、关节面二次塌陷率、失血量、手术时间和感染率进行Meta分析。结果:共纳入7项RCT研究，424例患者，其中骨替代物组296例，自体骨移植组128例。两组手术时间[MD=-16。79，95％CI(-25。72，-7。85)，P=0。000 2]，出血量[MD=-70。49，95％CI(-79。34，-61。65)，P＜0。000 01]比较，差异有统计学意义。而关节凹陷[MD=-0。17，95％CI(-0。91，0。58)，P=0。66]，关节面二次塌陷率[RR=-0。74，95％CI(0。35，1。57)，P=0。43]，感染率[RR=1。21，95％CI(0。31，4。70)，P=0。78]比较，差异无统计学意义。结论:骨替代物与 自体骨移植治疗胫骨平台骨折在关节凹陷、关节面二次塌陷率和感染率方面疗效相近。但骨替代物较自体骨移植，能减少失血量，缩短手术时间。
Meta-analysis of autologous bone grafts and bone substitute for the treatment of tibial plateau fractures
Objective To explore clinical efficacy of autologous bone grafts and bone substitute for the treatment of tibial plateau fractures by Meta analysis.Methods Controlled clinical studies on autogenous bone transplantation and bone substitutes in treating tibial plateau fractures published on PubMed,Web of Science,CNKI,Wanfang and other databases from January 2005 to August 2022 were searched by computer.Literature screening and data extraction were performed according to random-ized controlled trial(RCT),and the quality of RCT were evaluated by using intervention meta-analysis criteria in Cochrane man-ual.Meta-analysis of joint depression,secondary collapse rate of articular surface,blood loss,operative time and infection rate between two methods were performed by Rev Man 5.3 software.Results Seven RCT studies(424 patients)were included,296 patients in bone replacement group and 128 patients in autograft group.Operative time[MD=-16.79,95％CI(-25.72,-7.85),P=0.000 2]and blood loss[MD=-70.49,95％CI(-79.34,-61.65),P＜0.000 01]between two groups had statistically differ-ences,while joint depression[MD=-0.17,95％CI(-0.91,0.58),P=0.66],secondary collapse rate of joint surface[RR=-0.74,95％CI(0.35,1.57),P=0.43],infection rate[RR=1.21,95％CI(0.31,4.70),P=0.78]between two groups had no differences.Conclusion The effects of bone substitute and autograft for the treatment of tibial plateau fracture have similar effects in terms of joint depression,secondary articular surface collapse rate and infection rate.However,compared with autologous bone trans-plantation,bone replacement could reduce blood loss and shorten operation time.
Tibial plateau fractureAutologous bone graftBone substituteMeta-analysis
国家科技期刊平台
NSTL
万方数据
