Department of Orthopaedics, Washington University School of Medicine, St. Louis, Missouri, USA.
Arthroscopy. 2011 Sep;27(9):1275-88. doi: 10.1016/j.arthro.2011.03.088. Epub 2011 Aug 6.
The aim of this investigation was to compare reoperation rates and clinical outcomes after meniscal repair and partial meniscectomy.
A systematic literature review was performed to identify outcome studies of arthroscopic meniscal repair (inside-out, outside-in, and all-inside techniques) or partial meniscectomy in patients with traumatic meniscal tears. The studies included patients with no previous injuries or operations.
At short- and long-term follow-up, partial meniscectomy had a lower reoperation rate (1.4% [2 of 143] and 3.9% [52 of 1,319], respectively) than isolated meniscal repair (16.5% [47 of 284] and 20.7% [30 of 145], respectively). There was a slightly higher reoperation rate after partial lateral meniscectomy compared with partial medial meniscectomy. Repairs of the medial meniscus resulted in higher reoperation rates than repairs of the lateral meniscus. Meniscal repairs at the time of anterior cruciate ligament reconstruction had a lower failure rate than isolated repairs. In the limited number of studies with long-term clinical outcome scores, meniscal repair was associated with higher Lysholm scores and less radiologic degeneration than partial meniscectomy.
Whereas meniscal repairs have a higher reoperation rate than partial meniscectomies, they are associated with better long-term outcomes.
Level IV, systematic review of Level I-IV studies.
本研究旨在比较半月板修复和半月板部分切除术的再手术率和临床结果。
系统文献回顾，以确定关节镜半月板修复（内-外、外-内和全内技术）或半月板部分切除术治疗外伤性半月板撕裂患者的结局研究。这些研究纳入了无既往损伤或手术史的患者。
在短期和长期随访中，半月板部分切除术的再手术率低于半月板单纯修复术（分别为 1.4%[143 例中的 2 例]和 3.9%[1319 例中的 52 例]，以及 16.5%[284 例中的 47 例]和 20.7%[145 例中的 30 例]）。与半月板单纯修复术相比，外侧半月板部分切除术的再手术率略高。内侧半月板修复的再手术率高于外侧半月板修复。前交叉韧带重建时行半月板修复的失败率低于单纯修复。在具有长期临床结局评分的有限数量的研究中，半月板修复与较高的 Lysholm 评分和较少的放射学退变相关，优于半月板部分切除术。
尽管半月板修复的再手术率高于半月板部分切除术，但它与更好的长期结局相关。
IV 级，对 I-IV 级研究的系统评价。
