Department of Orthopaedic Surgery, Washington University School of Medicine, 1 Barnes-Jewish Hospital Plaza, West Pavilion 1130, St. Louis, MO 63010, USA.
J Bone Joint Surg Am. 2012 Dec 19;94(24):2222-7. doi: 10.2106/JBJS.K.01584.
Meniscal repair offers the potential to avoid the long-term articular cartilage deterioration that has been shown to result after meniscectomy. Failure of the meniscal repair can occur several years postoperatively. Limited evidence on the long-term outcomes of meniscal repair exists.
We performed a systematic review of studies reporting the outcomes of meniscal repair at a minimum of five years postoperatively. Pooling of data and meta-analysis with a random-effects model were performed to evaluate the results.
Thirteen studies met the inclusion criteria. The pooled rate of meniscal repair failure (reoperation or clinical failure) was 23.1% (131 of 566). The pooled rate of failure varied from 20.2% to 24.3% depending on the status of the anterior cruciate ligament (ACL), the meniscus repaired, and the technique utilized. The rate of failure was similar for the medial and the lateral meniscus as well as for patients with an intact and a reconstructed ACL.
A systematic review of the outcomes of meniscal repair at greater than five years postoperatively demonstrated very similar rates of meniscal failure (22.3% to 24.3%) for all techniques investigated. The outcomes of meniscal repair at greater than five years postoperatively have not yet been reported for modern all-inside repair devices.
半月板修复术有可能避免半月板切除术后出现的长期关节软骨恶化。半月板修复术后可能会在几年后失败。半月板修复的长期结果的证据有限。
我们对至少五年后报告半月板修复结果的研究进行了系统评价。采用随机效应模型进行数据合并和荟萃分析,以评估结果。
符合纳入标准的研究有 13 项。半月板修复失败(再次手术或临床失败)的总体发生率为 23.1%(566 例中有 131 例)。失败率的范围为 20.2%至 24.3%,取决于前交叉韧带(ACL)的状态、修复的半月板以及所采用的技术。内侧和外侧半月板以及 ACL 完整和重建的患者的失败率相似。
对术后五年以上半月板修复结果的系统评价显示,所有研究的半月板失败率(22.3%至 24.3%)非常相似。对于现代全内修复装置,尚未报道术后五年以上半月板修复的结果。