摘要
目的本研究旨在探讨在单髁置换术(UKA)中使用3D打印导板(PSI)对手术效果有何种影响。方法文献的纳入标准包括队列研究和随机对照试验(RCTs)、研究对象为初次行UKA的患者、干预措施同时包含PSI辅助UKA和传统UKA等。排除标准包括未包含所需结局指标的研究、随访脱落率过高的研究等。依此标准检索Web of Science、考克兰图书馆(The Cochrane Library)、荷兰医学文摘数据库(Embase)、PubMed、中国知网、万方、维普7个数据库,使用纽卡斯尔-渥太华量表(NOS)评价队列研究的质量,使用改良Jadad量表评价RCTs的质量,使用Revman 5.3软件进行Meta分析。结果共纳入9篇文献,包括5篇队列研究和4篇RCTs,均为高质量文献。Meta分析的结果显示,与传统器械相比,PSI可以减少胫骨假体冠状面[平均差(MD)=-1.09,95%置信区间(CI)(-1.50,-0.67),P<0.001]和矢状面[MD=-0.73,95%CI(-1.43,-0.02),P=0.04]的位置偏差,但可能会增加股骨假体冠状面的位置偏差[MD=0.89,95%CI(0.17,1.60),P=0.01],差异均有统计学意义。在髋膝踝角[MD=-0.13,95%CI(-0.72,0.46),P=0.66]、手术时间[MD=2.07,95%CI(-0.14,4.29),P=0.07]、美国特种外科医院(HSS)评分[MD=-0.70,95%CI(-1.71,0.31),P=0.17]以及假体位置异常数量[MD=0.64,95%CI(0.38,1.08),P=0.10]方面,PSI辅助UKA没有产生比传统UKA更好的效果,差异均无统计学意义。结论PSI辅助UKA对假体定位有一定帮助,但总体的手术效果与传统UKA无明显差别。
Objective To investigate the effect of 3D printed patient-specific instrumentation(PSI)on unicompartmental knee arthroplasty(UKA).Methods Inclusion criteria for literature study included:cohort studies and randomised controlled trials(RCTs),patients receiving UKA for the first time,surgical procedures involving both PSI-assisted UKA and conventional UKA.Exclusion criteria:studies that did not include the required outcome indicators,and studies with high dropout rates at follow-up,etc..Seven databases including Web of Science,The Cochrane Library,Excerpta Medica Database(Embase),PubMed,China National Knowledge Infrastructure(CNKI),China Online Journals(Wanfang)and China Science and Technology Journal Database(VIP)were retrieved based on above criteria.Newcastle-Ottawa scale(NOS)was applied to evaluate the quality of cohort studies.The improved Jadad scale was adopted to evaluate the quality of RCTs,and meta-analysis was performed using Revman 5.3.Results A total of nine works of literature were collected,including five cohort studies and four RCTs,all of which were of high quality.Results of the meta-analysis showed that PSI could reduce the coronal[mean difference(MD)=-1.09,95%confidence interval(CI)(-1.50,-0.67),P<0.001]and sagittal[MD=-0.73,95%CI(-1.43,-0.02),P=0.04]deviation of the tibial prosthesis compared with conventional instrumentation,but might increase the position deviation of the coronal plane of the femoral prosthesis[MD=0.89,95%CI(0.17,1.60),P=0.01].The differences were statistically significant.In terms of hip-knee-ankle angle[MD=-0.13,95%CI(-0.72,0.46),P=0.66],operation time[MD=2.07,95%CI(-0.14,4.29),P=0.07],Hospital for Special Surgery(HSS)score[MD=-0.70,95%CI(-1.71,0.31),P=0.17]and the number of outliers in prosthesis positions[MD=0.64,95%CI(0.38,1.08),P=0.10],PSI-assisted UKA did not deliver better results than conventional UKA,and the differences were not statistically significant.Conclusion Prosthesis localization can benefit from the PSI-assisted UKA,but the overall surgical effect may not
作者
马鹏程
张思平
柴浩
姜侃
Ma Pengcheng;Zhang Siping;Chai Hao;Jiang Kan(The Department of Joint Surgery of Sixth Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China;The Fourth Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)
出处
《中华关节外科杂志（电子版）》
CAS
CSCD
2023年第1期35-43,共9页
Chinese Journal of Joint Surgery(Electronic Edition)
关键词
骨关节炎
膝
关节成形术
置换
膝
打印
三维
外科器械
预后
Meta分析
Osteoarthritis
Arthroplasty,replacement,knee
Printing,three-dimensional
Surgical instruments
Prognosis
Meta-analysis
