Aryan Haratian, Ioanna K Bolia, Laith K Hasan, Amir Fathi, Samantha Solaru, Andrew Homere, Frank A Petrigliano, Alexander E Weber
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引用次数: 1
Abstract
Purpose: The purpose of this study was to systematically review the outcomes of arthroscopic management of meniscal cysts and to compare the results across the reported surgical techniques.
Methods: Following the PRISMA methodology, 3 databases (PubMed, Scopus and Web of Science) were searched from inception to June 2021 for randomized controlled trials (RCTs) and observational studies reporting outcomes on patients with meniscal cysts who underwent arthroscopic surgery. The Mixed Methods Appraisal Tool (MMAT) was used to evaluate the study quality.
Results: Eighteen studies examining 753 patients (761 meniscal cysts; 92.5% in the lateral meniscus) were included. Overall, 486/736 (66.0%) patients underwent purely arthroscopic decompression, 174/736 (23.6%) received arthroscopic excision, 58/736 (7.9%) received arthroscopy assisted percutaneous drainage, and 18/736 (2.4%) received a combined procedure. The recurrence rate for meniscal cysts was 7.1% across all arthroscopic procedures; 8.3%, 3.4%, and 0% for arthroscopic decompression, arthroscopic excision, and arthroscopy assisted percutaneous drainage, respectively. A total of 79.3% of patients returned to the same level of sport and 85.7% had resolution or minimal knee symptoms after arthroscopic surgery for meniscal cysts. Patient perception of surgical outcomes after any type of arthroscopic surgery for meniscal cysts was reported by 5 studies, with 189/203 (93.1%) reporting satisfaction with their surgical procedure.
Conclusion: Based on current evidence, arthroscopic management of meniscal cysts yields satisfactory patient outcomes, low cyst recurrence rates and high return to sport rates regardless of the surgical technique. Rates of cyst recurrence were relatively higher with arthroscopic decompression versus excision and percutaneous drainage; however, prospective studies using modern surgical techniques are necessary to better evaluate the surgical outcomes and to compare those with nonoperative modalities, given that a significant proportion of the included articles in this review were relatively outdated.
Level of evidence: Systematic review of level II and IV studies.
目的:本研究的目的是系统地回顾关节镜治疗半月板囊肿的结果，并比较报道的手术技术的结果。方法:采用PRISMA方法，检索了3个数据库(PubMed、Scopus和Web of Science)，从成立到2021年6月，检索了报告半月板囊肿患者接受关节镜手术结果的随机对照试验(rct)和观察性研究。采用混合方法评价工具(MMAT)对研究质量进行评价。结果:18项研究检查了753例患者(761例半月板囊肿;外侧半月板92.5%)。总体而言，486/736例(66.0%)患者接受了单纯的关节镜减压，174/736例(23.6%)接受了关节镜切除，58/736例(7.9%)接受了关节镜辅助经皮引流，18/736例(2.4%)接受了联合手术。所有关节镜手术中半月板囊肿的复发率为7.1%;关节镜减压、关节镜切除和关节镜辅助经皮引流分别为8.3%、3.4%和0%。在半月板囊肿的关节镜手术后，共有79.3%的患者恢复到相同的运动水平，85.7%的患者膝关节症状缓解或最小。5项研究报告了任何类型的半月板囊肿关节镜手术后患者对手术结果的感知，189/203(93.1%)报告对手术过程满意。结论:根据目前的证据，无论采用何种手术技术，关节镜治疗半月板囊肿可获得令人满意的患者结果，囊肿复发率低，恢复率高。关节镜下减压与经皮穿刺切除相比，囊肿复发率相对较高;然而，考虑到本综述中相当大比例的文章相对过时，使用现代手术技术的前瞻性研究对于更好地评估手术结果并与非手术方式进行比较是必要的。证据水平:II级和IV级研究的系统评价。
期刊介绍：
Orthopedic Research and Reviews is an international, peer-reviewed, open-access journal focusing on the patho-physiology of the musculoskeletal system, trauma, surgery and other corrective interventions to restore mobility and function. Advances in new technologies, materials, techniques and pharmacological agents will be particularly welcome. Specific topics covered in the journal include: Patho-physiology and bioengineering, Technologies and materials science, Surgical techniques, including robotics, Trauma management and care, Treatment including pharmacological and non-pharmacological, Rehabilitation and Multidisciplinarian care approaches, Patient quality of life, satisfaction and preference, Health economic evaluations. The journal welcomes submitted papers covering original research, basic science and technology, clinical studies, reviews and evaluations, guidelines, expert opinion and commentary, case reports and extended reports.
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