摘要
[目的]采用荟萃分析方法探讨体质对单髁置换术疗效的影响及安全性.[方法]计算机检索建库至2023年9月中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、Cochrane Library、Web Of Science等文献,使用RevMan 5.4对纳入文献进行荟萃分析.[结果]共纳入11篇文献,其中前瞻性研究3篇,回顾性研究8篇,均为高质量研究,共涉及3 624膝,其中肥胖组1 258膝,正常组2 366膝.荟萃分析结果显示,肥胖组与正常组在VAS评分、KSS评分、HSS评分及术后并发症发生率的差异无统计学意义(P＞0.05).但肥胖组OKS评分显著低于正常组(I2=89％,MD=-2.99,95％CI-5.18～-0.81,P=0.007),肥胖组术后关节活动度显著小于正常组(I2=34％,MD=-3.38,95％CI-4.32 -2.44,P＜0.001),肥胖组术后翻修率显著高于正常组(I2=23％,RR=1.51,95％CI1.06～2.14,P=0.02).[结论]与正常体质人相比,肥胖患者行UKA仍可获得较好临床结果,但肥胖患者术后OKS评分和膝关节活动度低于正常体质患者,且肥胖者术后翻修率增加.
Abstract
[Objective]To investigate the influence of body composition on outcome of unicompartmental knee arthroplasty by meta-analysis.[Methods]The literatures from CNKI,Wanfang,Weipu,China Biomedical Literature Database,PubMed,Embase,Cochrane Li-brary and Web of Science were searched by computer untill September 2023,and meta-analysis of the included literatures was performed using RevMan 5.4.[Results]A total of 11 literatures were included,including 3 prospective studies and 8 retrospective studies,all of which were high quality studies,involving a total of 3 624 knees,including 1 258 knees in the obese group and 2 366 knees in the normal group.As results of meta-analysis,there were no statistically significant differences in VAS score,KSS score,HSS score and incidence of postoperative complications between the obese group and the normal group(P＞0.05).However,the obese group was marked significantly lower postoperative OKS score(I2=89％,MD=-2.99,95％CI-5.18～0.81,P=0.007),and significantly less postoperative knee range of mo-tion(I2=34％,MD=-3.38,95％CI-4.32～2.44,P＜0.001),whereas significantly higher postoperative revision rate(P=23％,RR=1.51,95％CI 1.06～2.14,P=0.02)than the normal group.[Conclusion]Compared with those normal body composition,the obese patients do still ob-tain benefits from UKA,but with postoperative OKS score and knee joint motion inferior to the normal body composition patients,while in-creased postoperative revision surgery rate.
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