不同梯形假体治疗梯形掌关节骨性关节炎的有效性和安全性:系统回顾与元分析》。

IF 1.8 Q2 ORTHOPEDICS HAND Pub Date : 2024-11-01 Epub Date: 2023-07-02 DOI:10.1177/15589447231183172
Ishith Seth, Gabriella Bulloch, Nimish Seth, Quentin Fogg, David J Hunter-Smith, Warren M Rozen
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引用次数: 0

摘要

背景:梯形掌关节(TMCJ)是受骨关节炎(OA)影响最常见的手部关节,梯形假体关节置换术是一种治疗顽固性 OA 的潜在方法。本荟萃分析旨在研究各种梯形假体作为TMCJ OA介入治疗方案的有效性和安全性。方法:检索科学网、PubMed、Scopus、谷歌学术和 Cochrane 图书馆数据库中截至 2022 年 5 月 28 日的相关研究。遵循《系统综述和元分析首选报告项目》指南,并在 PROSPERO 上注册了研究方案。方法学质量由美国国家心肺血液研究所的观察性研究工具和 Cochrane 偏倚风险工具进行评估。对不同的置换植入物进行了分组分析;分析采用 Open Meta-Analyst 软件和 P 值 结果:共纳入了 123 项研究,包括 5752 名患者。全关节置换(TJR)植入物在术后视觉模拟量表疼痛评分方面有更显著的改善。带部分斜方肌切除的内固定假体具有最高的握力和最高的手臂、肩部和手部残疾(DASH)评分降低率。TJR的翻修率最高(12.3%),而带部分斜方肌切除术的内插手术的翻修率最低(6.2%)。结论:与其他植入物相比,全关节置换术和带斜方肌部分切除术的内固定植入物能更有效地改善疼痛评分、握力和 DASH 评分。未来的研究应侧重于比较不同植入物的高质量随机临床试验,以积累更高质量的证据和更可靠的结论。
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Efficacy and Safety of Different Trapezium Implants for Trapeziometacarpal Joint Osteoarthritis: A Systematic Review and Meta-Analysis.

Background: The trapeziometacarpal joint (TMCJ) is the most common hand joint affected by osteoarthritis (OA), and trapezium implant arthroplasty is a potential treatment for recalcitrant OA. This meta-analysis aimed to investigate the efficacy and safety of various trapezium implants as an interventional option for TMCJ OA. Methods: Web of Science, PubMed, Scopus, Google Scholar, and Cochrane library databases were searched for relevant studies up to May 28, 2022. Preferred Reported Items for Systematic Review and Meta-Analysis guidelines were adhered to, and the protocol was registered in PROSPERO. The methodological quality was assessed by National Heart, Lung, and Blood Institute tools for observational studies and the Cochrane risk of bias tool. Subgroup analyses were performed on different replacement implants; the analysis was done using Open Meta-Analyst software and P values <.05 were considered statistically significant. Results: A total of 123 studies comprising 5752 patients were included. Total joint replacement (TJR) implants demonstrate greater significant improvements in visual analogue scale pain scores postoperatively. Interposition with partial trapezial resection implants were associated with highest grip strength and highest reduction in the Disabilities of the Arm, Shoulder, and Hand (DASH) score. Revision rates were highest in TJR (12.3%) and lowest in interposition with partial trapezial resection (6.2%). Conclusion: Total joint replacement and interposition with partial trapezial resection implants improve pain score, grip strength, and DASH scores more than other implant options. Future studies should focus on high-quality randomized clinical trials comparing different implants to accumulate higher quality evidence and more reliable conclusions.

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来源期刊
HAND
HAND Medicine-Surgery
CiteScore
3.30
自引率
0.00%
发文量
209
期刊介绍: HAND is the official journal of the American Association for Hand Surgery and is a peer-reviewed journal featuring articles written by clinicians worldwide presenting current research and clinical work in the field of hand surgery. It features articles related to all aspects of hand and upper extremity surgery and the post operative care and rehabilitation of the hand.
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