| 蒋超,叶灿华,钱文伟,等.人工全膝关节置换术中两种截骨技术的系统评价.骨科,2016,7(5): 322-327. |
| 人工全膝关节置换术中两种截骨技术的系统评价 |
| Comparison between gap balancing and measured resection for total knee arthroplasty: a systematic review |
| 投稿时间：2016-06-29 |
| DOI：10.3969/j.issn.1674-8573.2016.05.007 |
| 中文关键词: 关节成形术，置换，膝 间隙平衡 测量截骨 系统综述 |
| 英文关键词: Arthroplasty, replacement, knee Gap balancing Measured resection Systematic review |
| 基金项目:国家自然科学基金（81572110、81171775） |
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| 摘要点击次数: 5361 |
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| 中文摘要: |
| 目的 比较分析间隙平衡法（gap balancing, GB）和测量截骨法（measured resection, MR）两种用于屈伸间隙和内外侧间隙平衡的截骨技术在人工全膝关节置换术中的应用效果。方法 在常用医学外文数据库中检索“gap balancing”、“measured resection”、“total knee arthroplasty”、“total knee replacement”，在常用医学中文数据库中检索“间隙平衡法”、“测量截骨法”、“测量切骨法”、“全膝关节置换术”、“间隙平衡”，并对入选文献的参考文献进行手工查阅作为补充材料，截止日期为2016年4月。经文题、摘要、全文内容等二次筛选，筛选出符合要求的文献，从内外间隙的平衡、股骨假体旋转、关节线、下肢力线、关节活动度、功能评分等方面比较GB和MR技术的优劣。结果 纳入5篇随机对照研究（RCT）和10篇队列研究。结果表明GB相对于MR能够获得更好的内外侧间隙的平衡，但是，其关节线较MR组明显升高。而在关节活动度、下肢力线、截骨量、功能评分和并发症等方面，两者无明显差异。结论 GB相对于MR能够获得更好的内外侧间隙的平衡，但是关节线明显抬高。两者在临床结果方面无明显差异，在临床实践中，应根据患者实际情况和医生熟悉的手术技术进行选择。 |
| 英文摘要: |
| Objective To compare gap balancing (GB) and measured resection (MR) in total knee arthroplasty (TKA). Methods The key words about “gap balancing”, “measured resection”, “total knee arthroplasty”, and “total knee replacement” were used to search articles in English and Chinese literature databases before April 2016. The articles have been filtrated by title, abstract and full text. The symmetric balanced flexion and extension gaps, femoral prosthesis rotation, joint-line, range of motion (ROM), function and quality-of-life outcomes were collected to evaluate the advantages and drawbacks of each method. Results Five RCTs and 10 cohort studies were included. The results showed that GB provided better symmetric balanced flexion and extension gaps and worse result about joint-line maintenance than MR. There was no significant difference in ROM, complications, function and quality-of-life outcomes between two methods. Conclusion The technique of GB sacrificed joint-line maintenance to improve gap symmetry. As there was no significant difference in function and quality-of-life outcomes, doctors should choose the technique according to the different knees and personal practice. |
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