体质对单髁置换术疗效影响的荟萃分析

A meta-analysis of the effect of body composition on outcome of unicompartmental knee arthroplasty

摘要:

[目的] 采用荟萃分析方法探讨体质对单髁置换术疗效的影响及安全性。[方法] 计算机检索建库至2023 年9 月中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、Cochrane Library、Web Of Science 等文献，使用RevMan5.4 对纳入文献进行荟萃分析。[结果] 共纳入11 篇文献，其中前瞻性研究3 篇，回顾性研究8 篇，均为高质量研究，共涉及3 624 膝，其中肥胖组1 258 膝，正常组2 366 膝。荟萃分析结果显示，肥胖组与正常组在VAS 评分、KSS 评分、HSS 评分及术后并发症发生率的差异无统计学意义（P＞0.05）。但肥胖组OKS 评分显著低于正常组（I2=89%, MD=-2.99, 95%CI -5.18~-0.81,P=0.007），肥胖组术后关节活动度显著小于正常组（I2=34%, MD=-3.38, 95%CI -4.32~-2.44, P＜0.001），肥胖组术后翻修率显著高于正常组（I2=23%, RR=1.51, 95%CI 1.06~2.14, P=0.02）。[结论] 与正常体质人相比，肥胖患者行UKA 仍可获得较好临床结果，但肥胖患者术后OKS 评分和膝关节活动度低于正常体质患者，且肥胖者术后翻修率增加。

Abstract:

[Objective] To investigate the influence of body composition on outcome of unicompartmental knee arthroplasty by metaanalysis.[Methods] The literatures from CNKI, Wanfang, Weipu, China Biomedical Literature Database, PubMed, Embase, Cochrane Li-brary and Web of Science were searched by computer untill September 2023, and meta-analysis of the included literatures was performedusing RevMan 5.4. [Results] A total of 11 literatures were included, including 3 prospective studies and 8 retrospective studies, all ofwhich were high quality studies, involving a total of 3 624 knees, including 1 258 knees in the obese group and 2 366 knees in the normalgroup. As results of meta-analysis, there were no statistically significant differences in VAS score, KSS score, HSS score and incidence ofpostoperative complications between the obese group and the normal group (P＞0.05). However, the obese group was marked significantlylower postoperative OKS score (I2= 89%, MD=-2.99, 95%CI -5.18~0.81, P=0.007), and significantly less postoperative knee range of mo-tion (I2=34%, MD=-3.38, 95%CI -4.32~-2.44, P＜0.001), whereas significantly higher postoperative revision rate (I2= 23%, RR=1.51, 95%CI 1.06~2.14, P=0.02) than the normal group. [Conclusion] Compared with those normal body composition, the obese patients do still ob-tain benefits from UKA, but with postoperative OKS score and knee joint motion inferior to the normal body composition patients, while in-creased postoperative revision surgery rate.