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Is there enough evidence to support hip capsular reconstruction? A systematic review of biomechanical studies
Journal of Hip Preservation Surgery ( IF 1.5 ) Pub Date : 2021-08-26 , DOI: 10.1093/jhps/hnab059
Hari K Ankem 1 , Vivian W Ouyang 1 , Benjamin R Saks 1 , Andrew E Jimenez 1 , Payam W Sabetian 1 , David R Maldonado 1 , Ajay C Lall 1 , Benjamin G Domb 1
Affiliation  

The aim of this study was to review and summarize the available biomechanical data on hip capsular reconstruction to guide clinical decision-making. A literature search was completed in December 2020 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify biomechanical cadaver studies on hip capsular reconstruction, hip capsulectomy or hip capsular defect. The investigated parameters included maximum distraction force, capsular state affecting range of motion (ROM), rotation and translation. Four studies met al. the inclusion–exclusion criteria. The median effective force for resisting maximum distraction for the reconstruction state, capsular defect state and the intact state was 171, 111 and 206 N, respectively. The defect capsule force was significantly lower (P = 0.00438) than the intact capsule force. The reconstruction state had a higher distraction force than that of the capsular defect, but due to heterogeneity, the overall effect size was not statistically significant. The capsular reconstruction state reduced excess motion and the degree of instability compared to the capsular defect state but restored the hip close to its native capsular state in the cadaveric model. When compared to capsulectomy/defect state, hip capsular reconstruction significantly improved the rotational stability and effective force at maximum distraction and minimized translation. However, no conclusions can be made regarding the most effective protocol due to the high heterogeneity between the four studies. Further biomechanical studies are needed to test various types of grafts under the same protocol.

中文翻译:

是否有足够的证据支持髋关节囊重建?生物力学研究的系统评价

本研究的目的是回顾和总结髋关节囊重建的可用生物力学数据,以指导临床决策。2020 年 12 月,使用系统评价和 Meta 分析指南的首选报告项目完成了文献检索,以确定关于髋关节囊重建、髋关节囊切除术或髋关节囊缺损的生物力学尸体研究。研究的参数包括最大牵引力、影响运动范围 (ROM) 的囊状态、旋转和平移。四项研究相遇。纳入排除标准。重建状态、囊缺损状态和完整状态抵抗最大牵引力的中位有效力分别为 171、111 和 206 N。缺陷胶囊力显着降低(P = 0. 00438)比完整的胶囊力。重建状态比包膜缺损具有更高的牵引力,但由于异质性,整体效应大小无统计学意义。与关节囊缺损状态相比,关节囊重建状态减少了过度运动和不稳定程度,但在尸体模型中将髋关节恢复到接近其天然关节囊状态。与关节囊切除术/缺损状态相比,髋关节囊重建显着提高了最大牵引力和最小化平移时的旋转稳定性和有效力。然而,由于四项研究之间的高度异质性,无法就最有效的方案得出结论。需要进一步的生物力学研究来测试相同协议下的各种类型的移植物。重建状态比包膜缺损具有更高的牵引力,但由于异质性,整体效应大小无统计学意义。与关节囊缺损状态相比,关节囊重建状态减少了过度运动和不稳定程度,但在尸体模型中将髋关节恢复到接近其天然关节囊状态。与关节囊切除术/缺损状态相比,髋关节囊重建显着提高了最大牵引力和最小化平移时的旋转稳定性和有效力。然而,由于四项研究之间的高度异质性,无法就最有效的方案得出结论。需要进一步的生物力学研究来测试相同协议下的各种类型的移植物。重建状态比包膜缺损具有更高的牵引力,但由于异质性,整体效应大小无统计学意义。与关节囊缺损状态相比,关节囊重建状态减少了过度运动和不稳定程度,但在尸体模型中将髋关节恢复到接近其天然关节囊状态。与关节囊切除术/缺损状态相比,髋关节囊重建显着提高了最大牵引力和最小化平移时的旋转稳定性和有效力。然而,由于四项研究之间的高度异质性,无法就最有效的方案得出结论。需要进一步的生物力学研究来测试相同协议下的各种类型的移植物。
更新日期:2021-08-26
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