[1]邱永琪,崔宏勋,岳松涛,等.Endobutton带袢钢板与Rigidfix可吸收横穿钉内固定治疗前交叉韧带损伤有效性和安全性的Meta分析[J].中医正骨,2023,35(01):36-42.
　QIU Yongqi,CUI Hongxun,YUE Songtao,et al.Clinical efficacy and safety of internal fixation with Endobutton plate versus absorbable Rigidfix cross-pins for treatment of anterior cruciate ligament injuries:a meta-analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(01):36-42.
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Endobutton带袢钢板与Rigidfix可吸收横穿钉内固定治疗前交叉韧带损伤有效性和安全性的Meta分析()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期数:
2023年01期
页码:
36-42
栏目:
文献研究
出版日期:
2023-01-20

文章信息/Info

Title:
Clinical efficacy and safety of internal fixation with Endobutton plate versus absorbable Rigidfix cross-pins for treatment of anterior cruciate ligament injuries:a meta-analysis
作者:
邱永琪1; 崔宏勋2; 岳松涛2; 水晓洋1; 王江一2; 王梁2; 郭马珑2
(1.河南中医药大学,河南 郑州 450046; 2.河南省洛阳正骨医院/河南省骨科医院,河南 郑州 450016)
Author(s):
QIU Yongqi1; CUI Hongxun2; YUE Songtao2; SHUI Xiaoyang1; WANG Jiangyi2; WANG Liang2; GUO Malong2
1.Henan University of Chinese Medicine,Zhengzhou 450046,Henan,China 2.Luoyang Orthopedic-Traumatological Hospital,Zhengzhou 450016,Henan,China
关键词:
前交叉韧带损伤;  Endobutton;  Rigidfix;  专题Meta分析
Keywords:
anterior cruciate ligament injuries;  Endobutton;  Rigidfix;  meta-analysis as topic
摘要:
目的:系统评价Endobutton带袢钢板与Rigidfix可吸收横穿钉内固定治疗前交叉韧带损伤的有效性和安全性。方法:通过计算机检索中国知网、万方数据库、维普网、中国生物医学文献服务系统、PubMed、Embase、Web of Science、Cochrane Library从数据库建库至2022年5月1日收录的比较Endobutton带袢钢板(Endobutton组)与Rigidfix可吸收横穿钉(Rigidfix组)内固定治疗前交叉韧带损伤的有效性和安全性的临床研究文献。由2名研究者独立依照纳入和排除标准对相关文献进行筛选和数据提取,并采用Cochrane偏倚风险评估工具对纳入研究的随机对照试验文献进行质量评估,采用纽卡斯尔-渥太华量表对纳入的回顾性临床研究文献进行质量评估。采用RevMan5.3软件进行Meta分析。结果:共检索到564篇文献,排除重复文献202篇,阅读题目和摘要后排除不相关文献248篇,阅读全文后排除97篇,最终纳入文献17篇,其中中文文献10篇、英文文献7篇。Meta分析结果显示,2组Lysholm膝关节评分、国际膝关节文献委员会(International Knee Documentation Committee,IKDC)评分、IKDC评分正常率、膝关节稳定性比较,组间差异均无统计学意义[Lysholm膝关节评分:MD=-0.05,95%CI(-0.43,0.33),P=0.800; IKDC评分:MD=0.25,95%CI(-1.08,1.58),P=0.710; IKDC评分正常率:RR=1.14,95%CI(0.94,1.38),P=0.170; 膝关节稳定性:MD=-0.10,95%CI(-0.30,0.10),P=0.340],Endobutton组术后并发症发生率低于Rigidfix组[RR=0.54,95%CI(0.30,0.97),P=0.040]。基于术后Lysholm评分的发表偏倚风险分析结果显示,14项研究的分布不完全对称,不排除存在发表偏倚的可能。结论:Endobutton带袢钢板与Rigidfix可吸收横穿钉内固定治疗前交叉韧带损伤的疗效相当,但前者安全性高于后者。
Abstract:
Objective:To systematically review the clinical efficacy and safety of internal fixation with Endobutton plate versus absorb-able Rigidfix cross-pins in the treatment of anterior cruciate ligament(ACL)injuries.Methods:All clinical trial articles about the clinical efficacy and safety of internal fixation with Endobutton plate(Endobutton group)versus absorbable Rigidfix cross-pins(Rigidfix group)for treatment of ACL injuries included from database establishing to May 1,2022 were retrieved from the China National Knowledge Internet,Wanfang Database,Vip Database,Chinese Biomedical Literature Service System,PubMed,Embase,Web of Science and Cochrane Library through computer.The articles were screened and the information was extracted independently by two researchers according to the inclusion and exclusion criteria,and if any disagreement was found between them,discussion was conducted or asked for another researcher for making a final decision.The methodological quality of researches in the randomized controlled trial(RCT)articles and retrospective clinical trial articles was evaluated by using Cochrane bias risk assessment tools and Newcastle-Ottawa scale(NOS)respectively,and then a Meta-analysis was conducted by using RevMan5.3 software.Results:Five hundred and sixty-four articles were searched out,and 202 repetitive articles were excluded in the initial stage.After screening through further reading titles and abstracts of the articles as well as the full texts of the remained articles in detail,248 and 97 articles were excluded respectively,17 articles were included in the final analysis,including 10 Chinese articles and 7 English articles.The results of Meta-analysis showed there was no significant difference between the 2 groups in Lysholm knee score,International Knee Documentation Committee(IKDC)score,normal rate of IKDC score and knee stability(Lysholm knee score:MD=-0.05,95%CI(-0.43,0.33),P=0.800; IKDC score:MD=0.25,95%CI(-1.08,1.58),P=0.710; normal rate of IKDC score:RR=1.14,95%CI(0.94,1.38),P=0.170; knee stability:MD=-0.10,95%CI(-0.30,0.10),P=0.340),while the rate of complications was lower in Endobutton group compared to Rigidfix group(RR=0.54,95%CI(0.30,0.97),P=0.040).Publication bias was analyzed according to funnel plot drawned based on Lysholm knee score,and the asymmetrical funnel plot indicated that there might be publication bias among the 14 studies.Conclusion:Internal fixation with Endobutton is similar to internal fixation with absorbable Rigidfix cross-pins in efficacy for treatment of ACL injuries,while the former displays the advantage of higher safety compared to the latter.

参考文献/References:

[1] 张强,郝光亮,李瑞,等.两种Rigidfix固定方式重建前交叉韧带近期疗效的随机对照研究[J].中国运动医学杂志,2019,38(12):1021-1026.
[2] LOPES O V Jr,DE FREITAS SPINELLI L,LEITE L H C,et al.Femoral tunnel enlargement after anterior cruciate ligament reconstruction using RigidFix compared with extracortical fixation[J].Knee Surg Sports Traumatol Arthrosc,2017,25(5):1591-1597.
[3] MOUSAVI H,MALEKI A,NOBAKHT A.Comparative study after hamstring anterior cruciate ligament reconstruction with Endobutton and Rigidfix:a clinical trial study[J].Adv Biomed Res,2017,6:136.
[4] IBRAHIM S A,ABDUL GHAFAR S,MARWAN Y,et al.Intratunnel versus extratunnel autologous hamstring double-bundle graft for anterior cruciate ligament reconstruction:a comparison of 2 femoral fixation procedures[J].Am J Sports Med,2015,43(1):161-168.
[5] 赵金伟,栾崇崇.关节镜下Endobutton与Rigidfix重建前交叉韧带的效果对比研究[J].中华养生保健,2021,39(12):41-43.
[6] 郑秋,张豪,肖世卓,等.自体肌腱单束重建前交叉韧带股骨端Endobutton固定与Rigidfix固定的临床对照研究[J].国际骨科学杂志,2020,41(6):365-370.
[7] 赵立连,卢明峰,邢基斯,等.Endobutton袢钢板与Rigidfix横穿钉股骨端固定自体腘绳肌腱重建前交叉韧带的转归[J].中国组织工程研究,2020,24(3):359-365.
[8] 李嘉,朴海旺,常乾坤,等.前交叉韧带解剖重建中不同股骨侧固定方式对术后骨道扩大的影响[J].实用医学杂志,2018,34(7):1162-1165.
[9] 李雁,姜兆伟,赵兴海,等.关节镜下前交叉韧带重建术股骨侧2种不同固定方式的疗效分析[J].中国骨与关节损伤杂志,2017,32(6):636-638.
[10] 许正文,苏长征,庞涛,等.Endobutton与Rigidfi两种固定方式对前交叉韧带重建术后股骨隧道变化的分析[J].中华临床医师杂志(电子版),2017,11(7):1121-1125.
[11] EAJAZI A,MADADI F,MADADI F,et al.Comparison of different methods of femoral fixation anterior cruciate ligament reconstruction[J].Acta Med Iran,2013,51(7):444-448.
[12] BASAD E,KIPPER A,WüSTEN O A,et al.Comparative study after hamstring ACL plasty with RigidFix(pin fixation)and EndoButton(anchor fixation)[J].Z Orthop Unfall,2010,148(3):276-281.
[13] CINAR B M,AKPINAR S,HERSEKLI M A,et al.The effects of two different fixation methods on femoral bone tunnel enlargement and clinical results in anterior cruciate ligament reconstruction with hamstring tendon graft[J].Acta Orthop Traumatol Turc,2009,43(6):515-521.
[14] BAUMFELD J A,DIDUCH D R,RUBINO L J,et al.Tunnel widening following anterior cruciate ligament reconstruction using hamstring autograft:a comparison between double cross-pin and suspensory graft fixation[J].Knee Surg Sports Traumatol Arthrosc, 2008,16(12):1108-1113.
[15] 孙健,刘畅,郑龙坡,等.Endobutton-Intrafix与Rigidfix-Intrafix固定自体腘肌腱重建前交叉韧带的临床对照研究[J].中国矫形外科杂志,2015,23(12):1086-1090.
[16] 涂俊,徐斌,徐洪港,等.Endobutton钢板及Rigidfix横穿钉固定自体腘绳肌腱重建前交叉韧带[J].中国组织工程研究与临床康复,2011,15(4):633-638.
[17] 刘军,鲁厚根,廖全明,等.关节镜下四股腘绳肌腱重建前交叉韧带疗效观察[J].中国内镜杂志,2010,16(11):1189-1191.
[18] 李宏云,陈世益,陈疾忤,等.自体腘绳肌腱重建前交叉韧带股骨端两种固定方式的比较[J].中国运动医学杂志,2010,29(1):22-25.
[19] 卢岩岩,王鸿雁,王明君,等.前交叉韧带重建术联合富血小板血浆关节腔注射治疗前交叉韧带损伤临床疗效和安全性的Meta分析[J].中医正骨,2022,325(4):18-24.
[20] ONO Y,SATO Y,MUKAI H,et al.Randomized comparative study of suspension femoral fixation device in graft position maintenance in anterior cruciate ligament reconstruction:EndoButton CL vs TightRope RT[J].Asia Pac J Sports Med Arthrosc Rehabil Technol,2021,25:42-46.
[21] URIBE-ECHEVARRIA B,MAGNUSON J A,AMENDOLA A,et al.Anterior cruciate ligament reconstruction:a com-parative clinical study between adjustable and fixed length suspension devices[J].Iowa Orthop J,2020,40(1):121-127.
[22] 叶俊星,戴涟生,程飞,等.关节镜下应用RigidFix或RigidLoop固定在膝前交叉韧带重建中的临床疗效比较[J].实用医学杂志,2022,38(4):395-398.
[23] LEE D H,SON D W,SEO Y R,et al.Comparison of femoral tunnel widening after anterior cruciate ligament reconstruction using cortical button fixation versus transfemoral cross-pin fixation:a systematic review and meta-analysis[J].Knee Surg Relat Res,2020,32(1):11.
[24] GüRPINAR T,POLAT B,EREN M,et al.The effect of soft tissue interposition of the Endobutton on clinical results and on its postoperative migration after single-bundle anterior cruciate ligament reconstruction[J].Knee,2020,27(6):1980-1987.
[25] 程松苗,胡勇,陈君蓉,等.Rigidfix横穿钉固定移植肌腱胫骨端重建前交叉韧带的临床研究[J].中医正骨,2020,32(8):12-16.
[26] 袁伟,齐玮,李春宝,等.RigidFix固定重建前交叉韧带的疗效研究[J].中华骨与关节外科杂志,2021,14(8):693-697.
[27] 罗建,高志朝,孟永骏,等.关节镜辅助下克氏针或空心钉内固定联合双Endobutton钢板内固定治疗内踝骨折合并下胫腓联合分离[J].中医正骨,2021,33(5):60-64.
[28] 刘日,高丽姝,魏海强,等.关节镜下胫骨侧双固定技术重建前交叉韧带[J].中国骨与关节损伤杂志,2021,36(4):409-411.
[29] HEXTER A T,HING K A,HADDAD F S,et al.Decellularized porcine xenograft for anterior cruciate ligament reconstruction:a histological study in sheep comparing cross-pin and cortical suspensory femoral fixation[J].Bone Joint Res,2020,9(6):293-301.
[30] WANG J,FAN H Q,DAI W,et al.Safety of the application of Rigidfix cross-pin system via different tibial tunnels for tibial fixation during anterior cruciate ligament reconstruction[J].BMC Musculoskelet Disord,2020,21(1):736.
(收稿日期:2022-05-11 本文编辑:时红磊)

相似文献/References:

[1]田玉鹏,汤善兵,褚向明,等.关节镜下Endobutton钢板联合指骨钢板内固定治疗 新鲜RockwoodⅢ型肩锁关节脱位[J].中医正骨,2015,27(05):21.

备注/Memo

备注/Memo:
通讯作者:郭马珑 E-mail:ml6542@126.com
更新日期/Last Update: 1900-01-01