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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Systematic Review and Meta-analysis of Osteochondral Autograft Transplantation versus Debridement in the Treatment of Osteochondritis Dessicans of the Capitellum
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Systematic Review and Meta-analysis of Osteochondral Autograft Transplantation versus Debridement in the Treatment of Osteochondritis Dessicans of the Capitellum

机译：骨软骨自体移植与清创术治疗前庭骨软骨炎的系统评价和荟萃分析

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Objectives: The purpose of this systematic review and meta- analysis is to compare clinical results and functional outcomes in patients with osteochondritis dessicans (OCD) lesions of the capitellum treated with either osteochondral autograft transplantation (OATS) or debridement with or without microfracture. Methods: Systematic review of multiple medical databases was performed after PROSPERO registration and using PRISMA guidelines. A literature search was performed using the multiple medical databases and the methodological quality of the individual studies was assessed by two review authors using the Cochrane Collaboration’s “Risk of Bias” tool. Case reports were excluded and only case series of more than five patients and higher level of evidence were included. All study, subject, and surgery parameters were collected. Data was analyzed using statistical software. Odds ratios (OR) were calculated when possible. Data were compared using Pearson Chi-Square and independent sample T tests when applicable. Results: Fifteen studies were included involving 368 patients (326 males and 42 females). There were a total of 197 patients in the debridement group and 171 patients in the OATS group. The mean age was 16.9 +/-4.1 for the debridement group and 14.6 +/-1.2 for the OATS group. Mean follow up was 29.0 +/-24.3 and 38.0 +/-12.8 for the debridement and OATS groups, respectively. Patients that underwent an OATS procedure had a statistically significant improvement in overall arc range of motion compared to patients that had a debridement (P≤0.001). When compared to patients with debridement, patients with OATS were 5.6 times more likely to return to at least their pre-injury level of sports participation (p≤0.002). Conclusion: Post-operative range of motion was significantly improved in patients undergoing an OATS procedure versus a debridement for OCD lesions of the capitellum. Patients with an OATS were 5.7 times more likely to return to at least the pre-injury level of sports participation compared to patients undergoing a debridement. Further studies are necessary in order to directly compare functional outcomes in patients undergoing a debridement procedures versus and OATS procedure.
机译：目的：本系统综述和荟萃分析的目的是比较经骨软骨自体移植（OATS）或有或无微骨折的清创术治疗的头皮骨软骨炎（OCD）病变患者的临床结果和功能结局。方法：在PROSPERO注册后并使用PRISMA指南对多个医学数据库进行系统审查。使用多个医学数据库进行了文献检索，并由两位评价作者使用Cochrane Collaboration的“偏见风险”工具评估了各个研究的方法学质量。病例报告被排除在外，仅包括超过五名患者和更高水平证据的病例系列。收集所有研究，受试者和手术参数。使用统计软件分析数据。在可能的情况下计算赔率（OR）。在适用时，使用Pearson卡方检验和独立样本T检验比较数据。结果：共纳入15项研究，涉及368例患者（男326例，女42例）。清创组共197例，OATS组共171例。清创组的平均年龄为16.9 +/- 4.1，OATS组的平均年龄为14.6 +/- 1.2。清创组和OATS组的平均随访分别为29.0 +/- 24.3和38.0 +/- 12.8。与进行清创术的患者相比，接受OATS手术的患者的总体弧运动范围有统计学上的显着改善（P≤0.001）。与清创患者相比，OATS患者至少回到受伤前的运动参与水平的可能性高5.6倍（p≤0.002）。结论：进行OATS手术的患者术后活动范围明显改善，而清除了前庭的OCD病变。与进行清创术的患者相比，患有OATS的患者至少回到受伤前的运动参与水平的可能性高5.7倍。为了直接比较接受清创术和OATS术的患者的功能结局，有必要进行进一步的研究。

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