同种异体半月板移植临床结果的荟萃分析△

Clinical results of meniscal allograft transplantation: a meta-analysis

摘要:

[目的]采用荟萃分析评估同种异体半月板移植（meniscalallografttransplantation,MAT）的临床效果。[方法]检索中国知网、中国生物医学文献、万方、维普、PubMed、Embase和Cochrane协作图书馆数据库自建库至2023年10月1日的文献，根据纳入标准收集MAT术后平均随访时间在10年及以上的文献。阅读全文提取效应量，通过RevMan5.3软件进行荟萃分析。[结果]最终纳入10篇文献、382例患者，共计395个半月板移植物，平均随访时间13.4年。荟萃结果显示，术前与术后 Tegner和VAS评分的差异均无统计学意义（P＞0.05）。与术前相比，术后Lysholm评分（MD=-18.29,95%CI-26.33~-10.26,P＜ 0.001）、KOOS评分[疼痛:(MD=-16.67,95%CI-28.63~-4.71,P=0.006);症状:(MD=-14.25,95%CI-26.52~-1.97,P=0.02);日常活动:(MD=-14.34,95%CI-21.33~-7.35,P＜0.001);运动和娱乐:(MD=-14.87,95%CI-24.84~-4.91,P=0.003);生活质量:(MD=-14.69, 95%CI-26.48~-2.90,P=0.010)]、IKDC评分（MD=-23.59,95%CI-27.42~-19.75,P＜0.001）、SF-36[身体功能: (MD=-15.98,95% CI-20.10~-11.87,P＜0.001);心理:(MD=-15.58,95%CI-20.97~-10.19,P＜0.001)]均显著增加，术后关节间隙显著减小（MD=0.88, 95%CI0.60~1.15,P＜0.001）。[结论]MAT具有良好的长期临床效果，可显著改善膝关节功能。

Abstract:

[Objective] To evaluate the clinical outcomes of meniscal allograft transplantation (MAT). [Methods] The literatures wereretrieved from CNKI, CBM, Wanfang, VIP, PubMed, Embase and Cochrane Collaborative Library databases up to October 1, 2023. Accord-ing to the inclusion criteria, literatures with an average follow-up time of 10 years or more after MAT were collected. After reading the full pa-per and extracting the data met the including criteria, a meta-analysis was conducted by using Revman 5.3 software. [Results] Ten papers,involving 382 patients, and 395 menisci, were included, with a mean follow-up of 13.4 years. As meta analysis results, there were no statisti-cally significant differences in terms of Tegner and VAS scores after MAT surgery compared with those before surgery (P＞0.05). However, ,Lysholm score (MD=-18.29, 95%CI -26.33~-10.26, P＜0.001); KOOS score [pain: (MD=-16.67, 95%CI -28.63~-4.71, P=0.006), symp-toms: (MD=-14.25, 95%CI -26.52~-1.97, P=0.02), activities of daily living: (MD=-14.34, 95%CI -21.33~-7.35, P＜0.001), sports and rec-reation: (MD=-14.87, 95%CI -24.84~-4.91, P=0.003), quality of life: (MD=-14.69, 95%CI -26.48~-2.90, P=0.010)]; IKDC score (MD=-23.59, 95%CI -27.42~-19.75, P＜0.001) and SF-36 [physical health (MD=-15.98, 95%CI -20.10~-11.87, P＜0.001) and mental health(MD=-15.58, 95%CI -20.97~-10.19, P＜0.001)] increased significantly after MAT compared with those before surgery. [Conclusion] MAThas a good long-term clinical consequences, which does effectively improve knee joint function.