Comparative analysis and validation of posterior cruciate ligament management in mobile-bearing total knee arthroplasty: Meta-analysis and animal study.

IF 1.6 4区 医学
Yuan-Shi Zhang, Hao-Yu Li, Lei Zhai, Gui-Zhou Zheng, Hong-Bo Xing, Shi-Xin Du, Xue-Dong Li
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引用次数: 0

Abstract

Total knee arthroplasty (TKA) is an effective treatment for end-stage knee joint diseases. The debate over preserving or sacrificing the posterior cruciate ligament (PCL) in mobile-bearing TKA (MB TKA) still needs to be solved due to the lack of high-quality evidence, particularly meta-analyses comparing these techniques. This study aims to conduct a meta-analysis to compare the outcomes of PCL retention (CR) and PCL sacrifice (PS) in terms of clinical and functional knee scores, range of motion, complication rates, and revision rates and to validate these findings through animal experiments. A comprehensive search was conducted using MEDLINE, Cochrane, and Embase databases. Relevant studies were selected for the meta-analysis using RevMan 5.3. Additionally, an animal experiment using Sprague-Dawley rats simulated MB TKA to compare the effects of PCL retention and sacrifice surgeries. 12 studies were included in the meta-analysis. No significant differences were found between CR and PS techniques regarding HSS, KSS, KSFS, WOMAC, ROM, and medial/lateral instability. However, CR MB showed slight superiority in NKJS, while PS MB had better outcomes in complication and revision rates. In the animal study, CR rats exhibited significant early postoperative inflammation, but both groups' knee structures gradually normalized. The meta-analysis indicates that PCL retention (CR MB) and sacrifice (PS MB) have similar effects on various clinical and functional knee scores. However, PS MB is significantly better at reducing complications and revision rates. The animal experiment confirms PS MB's advantages in reducing inflammation and promoting joint recovery. Despite the strong evidence, long-term follow-up and larger-scale randomized controlled trials are necessary to confirm these findings.

活动承载式全膝关节置换术中后交叉韧带处理的比较分析和验证:荟萃分析和动物实验。
全膝关节置换术(TKA)是治疗终末期膝关节疾病的有效方法。由于缺乏高质量的证据,尤其是缺乏比较这两种技术的荟萃分析,在活动承载式全膝关节置换术(MB TKA)中保留或牺牲后交叉韧带(PCL)的争论仍有待解决。本研究旨在进行一项荟萃分析,从临床和膝关节功能评分、活动范围、并发症发生率和翻修率等方面比较 PCL 保留(CR)和 PCL 牺牲(PS)的结果,并通过动物实验验证这些发现。我们使用 MEDLINE、Cochrane 和 Embase 数据库进行了全面检索。使用 RevMan 5.3 挑选出相关研究进行荟萃分析。此外,还使用 Sprague-Dawley 大鼠进行了模拟 MB TKA 的动物实验,以比较 PCL 保留和牺牲手术的效果。12 项研究被纳入荟萃分析。在HSS、KSS、KSFS、WOMAC、ROM和内侧/外侧不稳定性方面,CR和PS技术没有发现明显差异。不过,CR MB 在 NKJS 方面略胜一筹,而 PS MB 在并发症和翻修率方面效果更好。在动物实验中,CR 组大鼠在术后早期表现出明显的炎症,但两组大鼠的膝关节结构都逐渐恢复正常。荟萃分析表明,保留 PCL(CR MB)和牺牲 PCL(PS MB)对各种临床和膝关节功能评分的影响相似。然而,PS MB在减少并发症和翻修率方面明显更胜一筹。动物实验证实了 PS MB 在减少炎症和促进关节恢复方面的优势。尽管证据确凿,但仍需长期随访和更大规模的随机对照试验来证实这些发现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
自引率
0.00%
发文量
91
期刊介绍: Journal of Orthopaedic Surgery is an open access peer-reviewed journal publishing original reviews and research articles on all aspects of orthopaedic surgery. It is the official journal of the Asia Pacific Orthopaedic Association. The journal welcomes and will publish materials of a diverse nature, from basic science research to clinical trials and surgical techniques. The journal encourages contributions from all parts of the world, but special emphasis is given to research of particular relevance to the Asia Pacific region.
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