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首页> 外文期刊>Journal of athletic training >Tibiofemoral Osteoarthritis After Surgical or Nonsurgical Treatment of Anterior Cruciate Ligament Rupture: A Systematic Review
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Tibiofemoral Osteoarthritis After Surgical or Nonsurgical Treatment of Anterior Cruciate Ligament Rupture: A Systematic Review

机译：手术或非手术治疗前交叉韧带破裂后的胫股骨关节炎：系统评价

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Objective: To determine if surgical or nonsurgical treatment of anterior cruciate ligament rupture affects the prevalence of posttraumatic tibiofemoral osteoarthritis (OA). Data Sources: Studies published between 1983 and April 2012 were identified via EBSCOhost and OVID. Reference lists were then screened in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Study Selection: Studies were included if (a) treatment outcomes focused on a direct comparison of surgical versus nonsurgical treatment of anterior cruciate ligament rupture, (b) the prevalence of tibiofemoral OA was reported, and (c) they were written in English. Studies were excluded if (a) the included patients were treated with cast immobilization after surgery, (b) the mean follow-up was less than 10 years, or (c) the patients underwent anterior cruciate ligament revision surgery. Data Extraction: Two independent investigators reviewed the included articles using the Newcastle-Ottawa Scale. Frequency of OA, surgical procedure, nonsurgical treatments, and participant characteristics were extracted and summarized. We calculated prevalence (%) and 95% confidence intervals for treatment groups for each individual study and overall. We developed 2 × 2 contingency tables to assess the association between treatment groups (exposed had surgery, referent was nonsurgical treatment) and the prevalence of OA. Data Synthesis: Four retrospective studies were identified (140 surgical patients, 240 nonsurgical patients). The mean Newcastle-Ottawa Scale score was 5 (range = 4–6 [of 10] points). Average length of follow-up was 11.8 years (range = 10–14 years). The prevalence of OA for surgically treated patients ranged from 32.6% to 51.2% (overall = 41.4%, 95% confidence interval = 35.0%, 48.1%) and for nonsurgical patients ranged from 24.5% to 42.3% (overall = 30.9%, 95% confidence interval = 24.4%, 38.3%). Conclusions: Although OA prevalence was higher in the surgical treatment group at a mean follow-up of 11.8 years, no definitive evidence supports surgical or nonsurgical treatment after anterior cruciate ligament injury to prevent posttraumatic OA. Current studies have been limited by small sample sizes, low methodologic quality, and a lack of data regarding confounding factors.
机译：目的：确定前交叉韧带破裂的手术或非手术治疗是否会影响创伤后胫股骨关节炎（OA）的患病率。数据来源：1983年至2012年4月之间发表的研究通过EBSCOhost和OVID进行鉴定。然后根据“系统评价和荟萃分析的首选报告项目”（PRISMA）声明筛选参考名单。研究选择：包括以下研究：（a）治疗结果侧重于直接比较前十字韧带断裂的手术和非手术治疗;（b）胫骨股骨关节炎的患病率;以及（c）用英语撰写。如果（a）所纳入的患者在术后接受石膏固定治疗，（b）平均随访时间少于10年，或（c）患者接受了前交叉韧带翻修手术，则排除研究。数据提取：两名独立研究人员使用纽卡斯尔-渥太华量表对纳入的文章进行了审查。提取并总结了OA的频率，手术程序，非手术治疗和参与者特征。我们针对每个研究和总体计算了治疗组的患病率（％）和95％置信区间。我们制定了2×2列联表，以评估治疗组（暴露于手术，参考对象为非手术治疗）与OA患病率之间的关联。数据综合：确定了四项回顾性研究（140名手术患者，240名非手术患者）。纽卡斯尔-渥太华量表的平均得分为5（范围= 4–6 [10]分）。平均随访时间为11.8年（范围= 10-14年）。接受手术治疗的患者的OA患病率为32.6％至51.2％（总体= 41.4％，95％置信区间= 35.0％，48.1％），而非手术患者的OA患病率为24.5％至42.3％。 ％（总体= 30.9％，95％置信区间= 24.4％，38.3％）。结论：尽管手术治疗组的OA患病率较高，平均随访11.8年，但没有明确的证据支持前交叉韧带损伤后手术或非手术治疗可预防创伤后OA。当前的研究受到样本量小，方法学质量低以及缺乏有关混杂因素的数据的限制。

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