摘要目的 通过荟萃分析评价单束与双束重建前交叉韧带在恢复膝关节前直向、旋转稳定性及膝关节功能评分方面的临床疗效,为前交叉韧带重建方法的选择提供依据.方法 计算机检索Ovid Medline和Pubmed、Embase、Cochrane图书馆、中国生物医学文献数据库、维普中文科技期刊数据库关于单束和双束解剖重建前交叉韧带的临床随机对照研究.阅读评价文献质量并提取有效数据,采用RevMan 5.0.23软件进行统计分析,两种手术方法的KT测量值、Lysholm评分采用加权均数差评价,轴移试验及国际膝关节文献委员会(IKDC)分级评分采用优势比评价.结果 共纳入前瞻性临床随机对照研究8篇.荟萃分析结果显示两种重建交叉韧带方法KT测量值差异具有统计学意义,加权均数差值-0.35 mm[95%CI(-0.61～0.08),P=0.01],但差异不具有临床意义;轴移试验合并优势比1.64[95%CI(0.85～3.16),P=0.14];IKDC分级评分优势比1.80[95%CI(0.98～3.31),P=0.06);Lysholm评分加权均数差值-1.91[95%CI(-3.45～0.37),P=0.01],差异有统计学意义.结论 双束解剖重建前交叉韧带的近期临床疗效不优于单束重建.

abstractsObjective To evaluate clinical outcome after anterior cruciate ligament (ACL)reconstruction with double-bundle or single-bundle by meta-analysis. Methods Randomized controlled trials (RCTs) on differences of clinical outcomes of ACL reconstruction were retrieved in Ovid Medline, PubMed,Embase, Cochrane Library, CBM and VIP database. Relevant journals or conference proceedings were also searched manually. Then extracted the date of KT-1000 arthrometer, pivot-shift testing, Lysholm score and IKDC final score in these researches. RevMan 5.0. 23 software was used for data analyses. Results Eight prospective RCTs met the inclusion criteria. The combined results of meta-analysis indicated that there was statistical difference between two operative procedures on postoperative KT-1000 arthrometer side-to-side [WMD= -0.35, 95%CI ( -0.61, -0.08), P=0.01], Lysholm score [WMD= -1.91, 95%CI ( -3.45, -0. 37 ), P =0. 01 ]. But the difference of KT-1000 arthrometer side-to-side is demonstrated to be clinically insignificant. Others indicated that there was no statistical differences with respect to IKDC final score [ OR = 1.80, 95% CI (0. 98, 3.31 ), P =0. 06], having a normal or nearly normal pivot-shift testing [OR=1.64, 95%CI (0.85, 3. 16), P=0. 14]. Conclusions Double-bundle reconstruction does not result in clinically significant advantage when compared with single-bundle. The results do not support the theory that double-bundle reconstruction controls knee rotation better.