摘要
目的 比较缝合带增强与改良Broström修复治疗慢性踝关节外侧不稳定的有效性和安全性.方法 检索中国知网、万方、中华医学期刊全文数据库、PubMed、Web of Science数据库中比较缝合带增强与改良Broström修复治疗慢性踝关节外侧不稳定的临床研究,对纳入研究进行meta分析.组间异质性较小时采用固定效应模型进行分析,组间异质性较大时采用随机效应模型进行分析.随机对照试验采用改良Jadad评分量表进行文献质量评价,非随机对照试验采用纽卡斯尔-渥太华量表(Newcastle-Ottawa Scale,NOS)进行文献质量评价.结果 共11篇文献纳入meta分析.缝合带增强组398例,改良Broström修复组404例.Meta分析结果显示两组术后疼痛视觉模拟评分[SMD=-0.19,95％CI(-0.54,0.16),P=0.282]、距骨倾斜角[SMD=-0.37,95％CI(-0.84,0.11),P=0.128]、距骨前向位移[SMD=-0.61,95％CI(-1.47,0.24),P=0.220]的差异无统计学意义.缝合带增强组足踝能力测量-日常生活评分[SMD=0.70,95％CI(0.01,1.39),P=0.045]、足踝能力测量-运动评分[SMD=0.96,95％CI(0.15,1.77),P=0.020]、足踝结局评分-日常生活评分[SMD=1.21,95％CI(0.05,2.36),P=0.040]、足踝结局评分-运动评 分[SMD=1.60,95％CI(0.11,3.09),P=0.035]均大于改良 Broström 修复组、术后复发性不稳定的发生率低于改良Broström修复组[RR=0.34,95％CI(0.15,0.76),P=0.008].结论 缝合带增强治疗慢性踝关节外侧不稳定的术后日常活动能力和运动功能优于改良Broström修复、复发性不稳定的发生率低于改良Broström修复,两组疼痛缓解和影像学指标无显著差异.
Abstract
Objective To compare the efficacy and safety of suture tape augmentation versus modified Broström repair in the treatment of chronic lateral ankle instability.Methods CNKI,Wanfang,Chinese Medical Journal full-text Database,PubMed,and Web of Science databases were searched for clinical studies comparing suture tape augmentation and modified Brostrom repair in the treatment of chronic lateral ankle instability.Meta-analysis was performed on the included studies.Fixed-ef-fects models were used for analyses when heterogeneity between groups was small,and random-effects models were used when het-erogeneity between groups was large.The quality of literature was assessed using the Modified Jadad Rating Scale for randomized controlled trials and the Newcastle-Ottawa Scale(NOS)for non-randomized controlled trials.Results A total of 11 articles were included in the meta-analysis.There were 398 cases in the suture tape augmentation group and 404 cases in the modified Brostrom repair group.Meta-analysis showed no statistically significant differences between the two groups in postoperative pain visual analogue scores[SMD=-0.19,95％CI(-0.54,0.16),P=0.282],talar tilt angle[SMD=-0.37,95％CI(-0.84,0.11),P=0.128],and anterior displacement of the talus[SMD=-0.61,95％CI(-1.47,0.24),P=0.220].In the suture tape augmentation group,foot and ankle ability measure-daily living score[SMD=0.70,95％CI(0.01,1.39),P=0.045],foot and ankle ability measure-movement score[SMD=0.96,95％CI(0.15,1.77),P=0.020],foot and ankle outcome score-daily living score[SMD=1.21,95％C/(0.05,2.36),P=0.040],foot and ankle outcome score-movement score[SMD=1.60,95％CI(0.11,3.09),P=0.035]were greater than those in the modified Broström repair group,and the incidence of recurrent postoperative instability was lower than that in the modified Broström repair group[RR=0.34,95％CI(0.15,0.76),P=0.008],the difference was statistically significant.Conclusion Suture tape augmentation provides superior postoperative daily activity capacity and sports function compared to modified Broström repair in the treatment of chronic lateral ankle instability.Additionally,the incidence of recurrent instability is lower in the suture tape aug-mentation group.No significant differences were observed between the two groups regarding to pain relief and radiological outcomes.
维普
万方数据