Percutaneous kyphon balloon kyphoplasty has achieved encouraging results in the treatment ofosteoporotic compression fractures, both for correcting spinal deformities and relieving pain. Although kyphoplasty is a smal...Percutaneous kyphon balloon kyphoplasty has achieved encouraging results in the treatment ofosteoporotic compression fractures, both for correcting spinal deformities and relieving pain. Although kyphoplasty is a small invasion, the surgery itself has some defects such as more X-ray fluoroscopy time during the operation and accumulation of radiation dose causing harm to patients and operators, and the puncture is hard to achieve in a highly precise location.展开更多
BACKGROUND The conventional implant approach involves flap elevation,which may result in increased soft tissue and bone loss and postoperative morbidity.The flapless surgical technique,aided by three-dimensional medic...BACKGROUND The conventional implant approach involves flap elevation,which may result in increased soft tissue and bone loss and postoperative morbidity.The flapless surgical technique,aided by three-dimensional medical imaging equipment,is regarded as a possible alternative to the conventional approach to alleviate the above issues.Several studies have been performed regarding the role of flapless implant surgery.However,the results are inconsistent and there is no robust synthesis of long-term evidence to better inform surgeons regarding which type of surgical technique is more beneficial to the long-term prognosis of patients in need of implant insertion.AIM To compare the long-term clinical performance after flapless implant surgery to that after the conventional approach with flap elevation.METHODS PubMed,EMBASE,Cochrane Central Register of Controlled Trials,and grey literature databases were searched from inception to 23 September 2019.Randomised controlled trials (RCTs) and cohort studies comparing the long-term clinical performance after flapless implant surgery to that after the conventional approach over a follow-up of three years or more were induded.Meta-analyses were conducted to estimate the odds ratios (ORs) or mean differences (MDs) and their 95 To confidence intervals (CIs) between the long-term implant survival rate,marginal bone loss,and complication rate of the flapless and conventional groups.Subgroup analyses were carried out to account for the possible effects of the guided or free-hand method during flapless surgery.RESULTS Ten articles,including four RCTs and six cohort studies,satisfied the eligibility criteria and nine of them were inclded in the meta-analysis.There was no significant difference between the long-term implant survival rate [OR=1.30,95%CI (0.37,4.54),P=0.68],marginal bone loss [MD=0.01,95%CI (-0.42,0.44),P=0.97],and complication rate [OR=1.44,95%CI (0.77,2.68),P=0.25] after flapless implant surgery and the conventional approach.Moreover,subgroup analyses revealed that the展开更多
目的:探讨计算机导航间隙平衡技术对全膝关节置换术患者术后下肢功能恢复的影响。方法:回顾性分析2018年7月至2019年6月接受全膝关节置换术的106例膝关节骨性关节炎(osteoarthritis,OA)患者的临床资料,根据全膝关节置换术中截骨技术不...目的:探讨计算机导航间隙平衡技术对全膝关节置换术患者术后下肢功能恢复的影响。方法:回顾性分析2018年7月至2019年6月接受全膝关节置换术的106例膝关节骨性关节炎(osteoarthritis,OA)患者的临床资料,根据全膝关节置换术中截骨技术不同分为测量截骨组和间隙平衡组。测量截骨组61例,男24例,女37例;年龄45~77(63.35±4.26)岁;K-L分级,Ⅲ级41例,Ⅳ级20例,术中实施测量截骨技术。间隙平衡组45例,男17例,女28例;年龄45~78(64.03±4.31)岁;K-L分级,Ⅲ级29例,Ⅳ级16例,实施计算机导航间隙平衡技术。比较两组患者术中出血量、手术时间、切口长度、住院时间及术后并发症情况,分别于术前、术后12个月采用膝关节协会评分(Knee Society Knee Score,KSS)评价其临床疗效。结果:106例患者均获得随访,时间12~18(20.38±3.25)个月。两组术中出血量、手术时间分比较差异有统计学意义(P<0.05)。两组切口长度和住院时间比较差异无统计学意义(P>0.05)。术后12个月,间隙平衡组KSS总分(173.59±14.50)分优于测量截骨组(164.95±12.10)分(P<0.05)。两组患者随访期间未发生假体松动不良严重并发症,其他并发症发生率组间比较差异无统计学意义(P>0.05)。结论:全膝关节置换术中应用计算机导航间隙平衡技术利于OA患者术后下肢功能恢复,且术后未发生严重不良并发症,安全性高。展开更多
文摘Percutaneous kyphon balloon kyphoplasty has achieved encouraging results in the treatment ofosteoporotic compression fractures, both for correcting spinal deformities and relieving pain. Although kyphoplasty is a small invasion, the surgery itself has some defects such as more X-ray fluoroscopy time during the operation and accumulation of radiation dose causing harm to patients and operators, and the puncture is hard to achieve in a highly precise location.
基金the Graduate Student's Research and Innovation Fund of Sichuan University,No.2018YJSY108the China Postdoctoral Science Foundation Funded Project,No.2018M640931+1 种基金the Science and Technology Key Research and Development Program of Sichuan Province,No.2019YFS0142the National Natural Science Foundation of China,No.81901060.
文摘BACKGROUND The conventional implant approach involves flap elevation,which may result in increased soft tissue and bone loss and postoperative morbidity.The flapless surgical technique,aided by three-dimensional medical imaging equipment,is regarded as a possible alternative to the conventional approach to alleviate the above issues.Several studies have been performed regarding the role of flapless implant surgery.However,the results are inconsistent and there is no robust synthesis of long-term evidence to better inform surgeons regarding which type of surgical technique is more beneficial to the long-term prognosis of patients in need of implant insertion.AIM To compare the long-term clinical performance after flapless implant surgery to that after the conventional approach with flap elevation.METHODS PubMed,EMBASE,Cochrane Central Register of Controlled Trials,and grey literature databases were searched from inception to 23 September 2019.Randomised controlled trials (RCTs) and cohort studies comparing the long-term clinical performance after flapless implant surgery to that after the conventional approach over a follow-up of three years or more were induded.Meta-analyses were conducted to estimate the odds ratios (ORs) or mean differences (MDs) and their 95 To confidence intervals (CIs) between the long-term implant survival rate,marginal bone loss,and complication rate of the flapless and conventional groups.Subgroup analyses were carried out to account for the possible effects of the guided or free-hand method during flapless surgery.RESULTS Ten articles,including four RCTs and six cohort studies,satisfied the eligibility criteria and nine of them were inclded in the meta-analysis.There was no significant difference between the long-term implant survival rate [OR=1.30,95%CI (0.37,4.54),P=0.68],marginal bone loss [MD=0.01,95%CI (-0.42,0.44),P=0.97],and complication rate [OR=1.44,95%CI (0.77,2.68),P=0.25] after flapless implant surgery and the conventional approach.Moreover,subgroup analyses revealed that the
文摘目的:探讨计算机导航间隙平衡技术对全膝关节置换术患者术后下肢功能恢复的影响。方法:回顾性分析2018年7月至2019年6月接受全膝关节置换术的106例膝关节骨性关节炎(osteoarthritis,OA)患者的临床资料,根据全膝关节置换术中截骨技术不同分为测量截骨组和间隙平衡组。测量截骨组61例,男24例,女37例;年龄45~77(63.35±4.26)岁;K-L分级,Ⅲ级41例,Ⅳ级20例,术中实施测量截骨技术。间隙平衡组45例,男17例,女28例;年龄45~78(64.03±4.31)岁;K-L分级,Ⅲ级29例,Ⅳ级16例,实施计算机导航间隙平衡技术。比较两组患者术中出血量、手术时间、切口长度、住院时间及术后并发症情况,分别于术前、术后12个月采用膝关节协会评分(Knee Society Knee Score,KSS)评价其临床疗效。结果:106例患者均获得随访,时间12~18(20.38±3.25)个月。两组术中出血量、手术时间分比较差异有统计学意义(P<0.05)。两组切口长度和住院时间比较差异无统计学意义(P>0.05)。术后12个月,间隙平衡组KSS总分(173.59±14.50)分优于测量截骨组(164.95±12.10)分(P<0.05)。两组患者随访期间未发生假体松动不良严重并发症,其他并发症发生率组间比较差异无统计学意义(P>0.05)。结论:全膝关节置换术中应用计算机导航间隙平衡技术利于OA患者术后下肢功能恢复,且术后未发生严重不良并发症,安全性高。
