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Comparison of adverse events and postoperative mobilization following knee extensor mechanism rupture repair: A systematic review and network meta-analysis

机译：膝关节伸肌机制破裂修复后不利事件和术后动员的比较：系统综述与网络元分析

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Abstract Background Extensor mechanism rupture (EMR) of the knee is a rare but potentially debilitating injury that often occurs due to trauma. While a wide variety of surgical treatments have been reported, there is currently no consensus on the most successful treatment method. The timing of post-operative joint mobilization is also critical for successful recovery after EMR repair. Despite the traditional method of complete immobilization for 6 weeks, there is an increasing trend towards early post-operative knee mobilization. The purpose of this network meta-analysis was to compare adverse event rates and function outcomes between repair methods and between post-operative mobilization protocols. Methods MEDLINE, EMBASE, Web of Science, and Cochrane Central electronic databases were searched in August 2016 for observational studies involving repair of acute, traumatic EMRs. Data extraction included functional outcomes, adverse events, and additional surgeries. Cohort studies that were used in functional outcome analysis were assessed for risk of bias by the Newcastle-Ottawa Quality Assessment Scale (NOS). Results Twenty-three studies (709 patients) were included for adverse event analysis. There were no significant differences in adverse event or additional surgery rates between EMR repair methods However, early mobilization produced significantly higher adverse event rates (p=0.02) and total event rates (p Conclusions We performed the first network meta-analysis to date comparing treatment of EMRs. Our results support the current body of knowledge that there is no single superior repair method. Although there is an increasing trend towards early or immediate post-operative knee mobilization, we found that early mobilization is associated with significantly higher adverse event and total event rates compared to fixed immobilization for a minimum of 6 weeks, implicating an increased financial burden and decreased quality of life associated with early post-operative mobilization.
机译：摘要背景延伸机构膝关节的破裂（EMR）是一种罕见但潜在的衰弱损伤，通常由于创伤而发生。虽然报告了各种各样的手术治疗，但目前没有对最成功的治疗方法共识。操作后联合动员的时间对于EMR修复后成功恢复也是至关重要的。尽管有传统的全身固定方法6周，但早期术后膝关节动员都存在越来越大的趋势。该网络元分析的目的是比较修复方法与术后动员协议之间的不良事件率和功能结果。方法在2016年8月在2016年8月搜索了Medline，Embase，Science和Cochrane中央电子数据库，用于涉及修复急性创伤EMR的观察研究。数据提取包括功能结果，不良事件和额外的手术。在纽卡斯尔 - 渥太华质量评估规模（NOS）中评估了功能结果分析中使用的群组研究。结果二十三项研究（709名患者）包括不良事件分析。 EMR修复方法之间的不良事件或额外的手术率没有显着差异，然而，早期动员产生明显更高的不良事件率（P = 0.02）和总事件率（P结论我们对迄今为止比较治疗的第一个网络META分析EMRS。我们的结果支持目前没有单一的高级修复方法的知识体系。虽然早期或术后膝关节后膝关节动员的趋势越来越大，但我们发现早期动员与明显更高的不良事件和总相关联事件率与固定的固定化相比至少为6周，这意味着增加的财务负担和与年初动员的生活质量下降。

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