半月板根撕裂的修复-内侧半月板根修复和外侧半月板根修复有区别吗?系统回顾和荟萃分析。

IF 1.3 4区 医学 Q3 ORTHOPEDICS Journal of Orthopaedic Surgery Pub Date : 2023-05-01 DOI:10.1177/10225536231175233
Jun Ren Khoo, W P Yau
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引用次数: 0

摘要

目的:半月板完全根撕裂与半月板挤压有关;这会导致半月板功能的丧失和膝关节骨关节炎的加速。现有的小规模回顾性病例对照研究表明,内侧和外侧半月板根修复的结果是不同的。本荟萃分析旨在通过对文献中现有证据的系统回顾来研究这种差异是否存在。方法:通过系统检索PubMed、Embase和Cochrane图书馆,对评估手术修复后半月板根撕裂效果的研究进行了识别,这些研究采用重新评估MRI或二次关节镜检查。半月板挤压程度、修复后半月板根的愈合状况和修复后的功能评分是我们感兴趣的结果。结果:在纳入的732项研究中,本系统综述纳入了20项研究。624个膝关节和122个膝关节分别进行了MMPRT和lprt修复。MMPRT修复后的半月板挤压量为3.8±1.7 mm,明显大于lprt修复后的0.9±1.2 mm (p < 0.001)。在lprt修复后的再评估MRI上观察到明显更好的愈合结果(p < 0.001)。lprt术后Lysholm评分和IKDC评分也明显优于MMPRT修复(p < 0.001)。结论:与MMPRT修复相比,lprt修复导致半月板挤压明显减少,MRI上愈合效果明显更好,Lysholm/IKDC评分更高。这是我们所知的第一个荟萃分析,系统地回顾了MMPRT和lprt修复在临床、影像学和关节镜结果上的差异。
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Repair of meniscus root tear - Is there a difference between medial meniscus root repair and lateral meniscus root repair? A systematic review and meta-analysis.

Purpose: Complete meniscus root tear is associated with meniscus extrusion; this causes a loss of meniscus function and accelerated osteoarthritis of the knee. Existing small-scale retrospective case-control studies suggested that the outcomes were different between medial and lateral meniscus root repair. This meta-analysis aims to study whether such discrepancies exist via a systematic review of the available evidence in the literature.

Methods: Studies evaluating the outcomes of surgical repair of posterior meniscus root tears, with reassessment MRI or second-look arthroscopy, were identified through a systematic search of PubMed, Embase, and Cochrane Library. The degree of meniscus extrusion, healing status of the repaired meniscus root, and functional outcome scores after repair were the outcomes of interest.

Results: Among the 732 studies identified, 20 studies were included in this systematic review. 624 knees and 122 knees underwent MMPRT and LMPRT repair, respectively. The amount of meniscus extrusion following MMPRT repair was 3.8 ± 1.7 mm, which was significantly larger than the 0.9 ± 1.2 mm observed after LMPRT repair (p < 0.001). Significantly better healing outcomes were observed on reassessment MRI after LMPRT repair (p < 0.001). The postoperative Lysholm score and IKDC score was also significantly better after LMPRT than MMPRT repair (p < 0.001).

Conclusions: LMPRT repairs resulted in significantly less meniscus extrusion, substantially better healing outcomes on MRI, and superior Lysholm/IKDC scores, when compared to MMPRT repair. This is the first meta-analysis we are aware of that systematically reviews the differences in the clinical, radiographic, and arthroscopic results of MMPRT and LMPRT repair.

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来源期刊
Journal of Orthopaedic Surgery
Journal of Orthopaedic Surgery ORTHOPEDICS-SURGERY
CiteScore
3.10
自引率
0.00%
发文量
91
审稿时长
13 weeks
期刊介绍: Journal of Orthopaedic Surgery is an open access peer-reviewed journal publishing original reviews and research articles on all aspects of orthopaedic surgery. It is the official journal of the Asia Pacific Orthopaedic Association. The journal welcomes and will publish materials of a diverse nature, from basic science research to clinical trials and surgical techniques. The journal encourages contributions from all parts of the world, but special emphasis is given to research of particular relevance to the Asia Pacific region.
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