摘要
目的:本篇Meta分析汇总相关研究结果,评价机器人辅助全髋关节置换术(THA)和传统全髋关节置换术疗效的差异。方法:检索PubMed、Cochrane Library、荷兰医学文摘(Embase)以及万方、维普、中国知网。纳入标准包括研究对象为初次接受THA的患者、干预措施包含机器人辅助THA和传统THA等。排除标准包括单独的病例报告、结局指标没有量化或数据不完整的研究等。纳入比较机器人辅助THA和传统THA疗效的队列研究和随机对照试验,分别使用Newcastle-Ottawa Scale(NOS)量表和Jadad量表进行质量评价,利用Revman 5.3软件进行Meta分析。结果:共纳入19篇文献,其中3篇为随机对照试验,16篇为队列研究,文献质量均较高。分析结果显示机器人辅助THA比传统THA手术时间更长[均数差(MD)=15.23,95%置信区间(CI)(8.02,22.44),P<0.001],髋臼假体置入Lewinnek安全区的概率更高[比值比(OR)=5.47,95%CI(3.96,7.57),P<0.001],髋关节偏心距的差异更小[MD=-0.76,95%CI(-1.10,-0.43),P<0.001],下肢长度的差异也更小[MD=-1.47,95%CI(-2.12,-0.82),P<0.001]。而在并发症(P=0.10)以及髋臼假体的前倾角(P=0.40)与外展角(P=0.43)两个方面两组结果相似。结论:机器人辅助THA增加了手术时间,但未增加并发症发生率。机器人辅助THA可提高髋臼假体置入的安全性,使下肢位置更合理,效果优于传统THA。
Objective To summearize the relevant research results and to evaluate the efficacy difference between robot-assisted total hip arthroplasty(THA)and traditional total hip arthroplasty.Methods PubMed,the Cochrane Library,Excerpta Medica Database(Embase),China Online Journals(Wanfang),China Science and Technology Journal Database(VIP),and China National Knowledge Infrastructure(CNKI)were adopted in the information retrieval,the inclusion criteria were research objects receiving THA for the first time,and interventions containing robot-assisted THA and traditional THA,etc.The exclusion criteria were separate case reports,studies without quantified outcome indicators or data integrity,etc.Cohort studies and randomized controlled trials were included to conduct the efficacy comparison between robot-assisted THA and traditional THA,with the application of the Newcastle-Ottawa Scale(NOS)and Jadad scale for quality evaluation respectively.Revman 5.3 software was applied for meta-analysis.Results Nineteen literatures were included in the total,in which three literatures were randomized controlled trials and 16 literatures were cohort studies,all literatures being with high quality.The results suggested that robot-assisted THA exhibited longer operation time than that of traditional THA[mean difference(MD)=15.23,95%confidence interval(CI)(8.02,22.44),P<0.001],higher probability of acetabular prosthesis implantation into Lewinnek safety zone[odds ratio(OR)=5.47,95%C/(3.96,7.57),P<0.001],smaller difference of global offset[MD=-0.76,95%CI(-1.10,-0.43),P<0.001]and smaller difference of lower leglength discrepancy[MD=-1.47,95%CI(-2.12,-0.82),P<0.001].Results of the two groups showed similarity in complications(P=0.10),anteversion angle(P=0.40),and abduction angle(P=0.43)of the acetabular prosthesis.Conclusions Robot-assisted THA extends the operation time,without leading to an increase of complication's incidence.Robot-assisted THA enables the improvement of acetabular prosthesis implantation safety,and enhancement in the positi
作者
马鹏程
张思平
柴浩
姜侃
Ma Pengcheng;Zhang Siping;Chai Hao;Jiang Kan(The sixth affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)
出处
《中华关节外科杂志（电子版）》
CAS
CSCD
2022年第3期329-336,共8页
Chinese Journal of Joint Surgery(Electronic Edition)
关键词
关节成形术
置换
髋
机器人手术
手术后并发症
META分析
Arthroplasty,replacement,hip
Robotic surgical procedures
Postoperative complications
Meta-analysis
