摘要
目的:近年许多学者将3D打印个性化截骨导板技术应用在全膝关节置换中,然而相较于传统手术,3D打印个性化截骨技术能否获得更好的下肢力线和疗效,仍存在较大争议。采用Meta分析方法比较3D打印个性化截骨导板和传统全膝关节置换下肢力线的准确性和疗效。方法:分别在中文数据库(万方医学、中国知网、维普、中国生物医学数据库)和英文数据库(Ovid,PubMed,Web of Science,Embase,Cochrane Library数据库)检索3D打印个性化截骨导板和传统手术全膝关节置换的前瞻性随机对照试验,使用Cochrane 5.1.0偏倚风险评估工具对纳入研究的质量进行评估,采用RevMan 5.3软件进行数据分析。结果:①通过制定的检索式共检索出中英文文献775篇,最终纳入30项随机对照试验;②Meta分析结果显示:与传统手术组相比,3D打印个性化截骨导板组髋-膝-踝角偏差值(MD=-0.51,95%CI:-0.66至-0.36,P<0.00001)、冠状面股骨组件角偏差值(MD=-0.33,95%CI:-0.39至-0.27,P<0.00001)及偏差人数(RR=0.52,95%CI:0.44-0.63,P<0.00001)、冠状面胫骨组件角偏差值(MD=-0.21,95%CI:-0.32至-0.10,P=0.0002)、矢状面股骨组件角偏差值(SMD=-0.16,95%CI:-0.26至-0.07,P=0.00009)、冠状面胫骨组件角偏差值(MD=-0.21,95%CI:-0.32至-0.10,P=0.0002)、术后引流量(SMD=-1.11,95%CI:-1.49至-0.74,P<0.0001)、出血量(MD=-48.60,95%CI:-68.50至-28.69,P<0.0001)均显著降低,KSS功能评分明显改善(MD=3.29,95%CI:1.35-5.23,P=0.0009)。结论:现有的研究证据表明,相比较传统全膝关节置换,全膝关节置换中应用3D打印个性化截骨导板技术,能获得更加准确的下肢力线和假体位置。
OBJECTIVE:Many scholars have applied 3D printing personalized osteotomy guide technology in patients undergoing total knee arthroplasty.However,there is still a great controversy on whether 3D printing personalized osteotomy technology can obtain better lower limb force line and more satisfactory curative effect than conventional total knee arthroplasty.This study aimed to compare the accuracy and clinical efficacy of 3D printed personalized osteotomy guide and conventional total knee arthroplasty by meta-analysis.METHODS:We retrieved controlled clinical trials which compared the 3D printing personalized osteotomy guide technology and conventional total knee arthroplasty respectively in Chinese databases(Wanfang,CNKI,VIP,and Chinese Biological Medicine)and English databases(Ovid,PubMed,Web of Science,Embase,and the Cochrane Library).Cochrane 5.1.0 bias risk assessment tool was used to evaluate the quality of included studies.The data were analyzed by RevMan 5.3 software.RESULTS:(1)A total of 775 Chinese and English articles were retrieved and 30 controlled clinical trials were included for final analysis.(2)Meta-analysis results showed that compared with the conventional group,the hip-knee-ankle angle(MD=-0.51,95%CI:-0.66 to-0.36,P<0.00001),deviation of femoral coronal alignment(MD=-0.33,95%CI:-0.39 to-0.27,P<0.00001),the number of femoral coronal alignment outliers(RR=0.52,95%CI:0.44-0.63,P<0.00001),the deviation of tibial coronal alignment(MD=-0.21,95%CI:-0.32 to-0.10,P=0.0002),the deviation of femoral sagittal alignment(SMD=-0.16,95%CI:-0.26 to-0.07,P=0.00009),the deviation of tibial sagittal alignment(MD=-0.21,95%CI:-0.32 to-0.10,P=0.0002),postoperative drainage volume(SMD=-1.11,95%CI:-1.49 to-0.74,P<0.0001),and intraoperative bleeding(MD=-48.60,95%CI:-68.50 to-28.69,P<0.0001)were less and KSS score(MD=3.29,95%CI:1.35-5.23,P=0.0009)was better in 3D printing personalized osteotomy guide group.CONCLUSION:In this meta-analysis,3D printing personalized osteotomy guide technology in total knee arthroplasty has adv
作者
柴浩
杨德勇
张磊
舒莉
Chai Hao;Yang Deyong;Zhang Lei;Shu Li(First Department of Joint Surgery,Sixth Affiliated Hospital of Xinjiang Medical University,Urumqi 830002,Xinjiang Uygur Autonomous Region,China;First Department of Surgery,Hospital Affiliated to Xinjiang Production and Construction Corps of Chinese People’s Armed Police Forces,Urumqi 830002,Xinjiang Uygur Autonomous Region,China)
出处
《中国组织工程研究》
CAS
北大核心
2023年第4期646-654,共9页
Chinese Journal of Tissue Engineering Research
基金
新疆维吾尔自治区卫生健康青年医学科技人才专项科研项目(WJWY-202024)
项目负责人:舒莉。
关键词
膝关节置换
3D打印
截骨导板
传统手术
假体力线
KSS功能评分
疼痛
META分析
total knee arthroplasty
3D printing
personalized osteotomy guide
conventional instrumentation
prosthesis force line
KSS function score
pain
meta-analysis
