{"title":"全膝关节置换术中外侧支持带释放与无释放的疗效：一项系统回顾和荟萃分析。","authors":"Yue Zou, Cuiqin Cao, Xiujiang Sun, Guodong Zhang","doi":"10.1186/s40001-025-03201-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of lateral patellar retinacular release (LPRR) versus no release in total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>This PRISMA-compliant systematic review searched PubMed, Embase, Web of Science, Cochrane Library, CNKI, CBM, Wanfang, and VIP from inception to August 2024. We included comparative studies of TKA patients with vs without LPRR (n = 8 studies, 3,911 patients).</p><p><strong>Exclusion criteria: </strong>incomplete data, combined procedures, cadaveric/artificial models. Random-effects models analyzed outcomes; heterogeneity assessed via I<sup>2</sup> statistics.</p><p><strong>Results: </strong>Primary outcomes: LPRR significantly reduced anterior knee pain (OR = 0.23, 95% CI 0.13-0.42, P < 0.00001; I<sup>2</sup> = 0%) and improved Knee Society Score (KSS) (MD = 3.00, 95% CI 1.10-4.89, P = 0.002; I<sup>2</sup> = 0%) but increased infection rate (OR = 3.44, 95%CI 1.48-8.04, P = 0.004; I<sup>2</sup> = 26%). Secondary outcomes showed no significant differences (P > 0.05).</p><p><strong>Conclusion: </strong>LPRR reduces anterior knee pain but significantly increases infection risk (NNH = 32). Should be reserved for patients with intraoperative patellar maltracking after risk-benefit assessment. Findings are limited by predominant Asian cohorts, short follow-up durations, and heterogeneous surgical indications.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"911"},"PeriodicalIF":3.4000,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481734/pdf/","citationCount":"0","resultStr":"{\"title\":\"Efficacy of lateral retinacular release versus no release in total knee arthroplasty: a systematic review and meta-analysis.\",\"authors\":\"Yue Zou, Cuiqin Cao, Xiujiang Sun, Guodong Zhang\",\"doi\":\"10.1186/s40001-025-03201-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To evaluate the efficacy and safety of lateral patellar retinacular release (LPRR) versus no release in total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>This PRISMA-compliant systematic review searched PubMed, Embase, Web of Science, Cochrane Library, CNKI, CBM, Wanfang, and VIP from inception to August 2024. We included comparative studies of TKA patients with vs without LPRR (n = 8 studies, 3,911 patients).</p><p><strong>Exclusion criteria: </strong>incomplete data, combined procedures, cadaveric/artificial models. Random-effects models analyzed outcomes; heterogeneity assessed via I<sup>2</sup> statistics.</p><p><strong>Results: </strong>Primary outcomes: LPRR significantly reduced anterior knee pain (OR = 0.23, 95% CI 0.13-0.42, P < 0.00001; I<sup>2</sup> = 0%) and improved Knee Society Score (KSS) (MD = 3.00, 95% CI 1.10-4.89, P = 0.002; I<sup>2</sup> = 0%) but increased infection rate (OR = 3.44, 95%CI 1.48-8.04, P = 0.004; I<sup>2</sup> = 26%). Secondary outcomes showed no significant differences (P > 0.05).</p><p><strong>Conclusion: </strong>LPRR reduces anterior knee pain but significantly increases infection risk (NNH = 32). Should be reserved for patients with intraoperative patellar maltracking after risk-benefit assessment. Findings are limited by predominant Asian cohorts, short follow-up durations, and heterogeneous surgical indications.</p>\",\"PeriodicalId\":11949,\"journal\":{\"name\":\"European Journal of Medical Research\",\"volume\":\"30 1\",\"pages\":\"911\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-09-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481734/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Medical Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s40001-025-03201-2\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Medical Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s40001-025-03201-2","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
摘要
目的：评价全膝关节置换术（TKA）中髌骨外侧支持带松解（LPRR）与不松解（LPRR）的疗效和安全性。方法：本系统评价符合prisma标准，检索了PubMed、Embase、Web of Science、Cochrane Library、CNKI、CBM、万方、VIP等数据库，检索时间为建站至2024年8月。我们纳入了合并与不合并LPRR的TKA患者的比较研究（n = 8项研究，3,911例患者）。排除标准：数据不完整、联合操作、尸体/人工模型。随机效应模型分析结果；通过I2统计评估异质性。结果：主要结果：LPRR显著减轻膝关节前疼痛（OR = 0.23, 95%CI 0.13-0.42, P 2 = 0%），改善膝关节社会评分（KSS） （MD = 3.00, 95%CI 1.10-4.89, P = 0.002; I2 = 0%），但增加感染率（OR = 3.44, 95%CI 1.48-8.04, P = 0.004; I2 = 26%）。次要结局差异无统计学意义（P < 0.05）。结论：LPRR减轻了膝关节前侧疼痛，但明显增加了感染风险（NNH = 32）。在风险-收益评估后，应保留给术中髌骨错位的患者。研究结果受限于主要的亚洲队列、较短的随访时间和不同的手术指征。
Efficacy of lateral retinacular release versus no release in total knee arthroplasty: a systematic review and meta-analysis.
Objective: To evaluate the efficacy and safety of lateral patellar retinacular release (LPRR) versus no release in total knee arthroplasty (TKA).
Methods: This PRISMA-compliant systematic review searched PubMed, Embase, Web of Science, Cochrane Library, CNKI, CBM, Wanfang, and VIP from inception to August 2024. We included comparative studies of TKA patients with vs without LPRR (n = 8 studies, 3,911 patients).
Results: Primary outcomes: LPRR significantly reduced anterior knee pain (OR = 0.23, 95% CI 0.13-0.42, P < 0.00001; I2 = 0%) and improved Knee Society Score (KSS) (MD = 3.00, 95% CI 1.10-4.89, P = 0.002; I2 = 0%) but increased infection rate (OR = 3.44, 95%CI 1.48-8.04, P = 0.004; I2 = 26%). Secondary outcomes showed no significant differences (P > 0.05).
Conclusion: LPRR reduces anterior knee pain but significantly increases infection risk (NNH = 32). Should be reserved for patients with intraoperative patellar maltracking after risk-benefit assessment. Findings are limited by predominant Asian cohorts, short follow-up durations, and heterogeneous surgical indications.
期刊介绍：
European Journal of Medical Research publishes translational and clinical research of international interest across all medical disciplines, enabling clinicians and other researchers to learn about developments and innovations within these disciplines and across the boundaries between disciplines. The journal publishes high quality research and reviews and aims to ensure that the results of all well-conducted research are published, regardless of their outcome.
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