目的 以Meta分析方法研究髌骨周围电灼去神经化对保留髌骨的全膝关节置换术(TKA)膝前痛和膝关节功能的影响.方法 检索关于保留髌骨行髌骨周围电灼去神经化TKA的相关文献,按照特定的纳入和排除标准筛选文献并提取相关数据,用Review Manager 5.0软件进行Meta 分析.结果共纳入四篇随机对照研究.分析表明髌骨周围电灼去神经化对保留髌骨的TKA患者术后膝前痛的发生率无影响[RR=0.76,95%CI (0.59,1.00),P=0.05],但是可以改善其的Feller髌骨评分[MD=1.15,95%CI (0.74,1.55),P〈0.01],KSS评分系统-膝关节评分[MD=1.30,95%CI (0.23,2.37),P〈0.05]和KSS评分系统-膝关节功能评分[MD=1.45,95%CI (0.08,2.81),P〈0.05].结论 在保留髌骨的全膝关节置换术中使用髌骨边缘电灼去神经化能改善术后膝前痛和膝关节功能.
Objective To investigate the effects of circumpatellar electrocautery on the anterior pain and the knee function after the total knee arthroplasty without patellar resurfacing using Meta-analysis. Methods The literatures about the effects of the circumpatellar electrocautery in total knee arthroplasty without patellar resurfacing were searched and the related data were extracted under special inclusion and exclusion criteria. The extracted data were analyzed by the Review Manager 5.0. Results Four randomized control trials (RCTs) were eligible for Meta-analysis. There were no statistically significant differences between the electrocautery group and the non electrocautery group about the incidence of anterior knee pain [RR =0. 76, 95%CI (0. 59, 1.00), P =0. 05]. However, the Feller knee score [MD = 1.15, 95%CI (0.74, 1.55), P〈0.011, the knee score [MD=1.30, 95%CI (0.23, 2.37), P〈0.05] and the function score [MD = 1.45, 95% CI (0.08, 2. 81 ), P〈0. 05 ] of Knee Society Clinical Rating System (KSS) were increased, compared with non electrocautery group. Conclusion The circumpatellar electrocautery in total knee arthroplasty without patellar resurfacing can relieve the anterior knee pain and improve the clinical outcome.