Nawabi Danyal H, Cro Suzie, Hamid Imran P, Williams Andy
Hospital for Special Surgery, New York, New York, USA
Medical Research Council Clinical Trials Unit, London, UK.
Am J Sports Med. 2014 Sep;42(9):2193-8. doi: 10.1177/0363546514540271. Epub 2014 Jul 17.
Meniscectomy is frequently performed in elite soccer athletes to allow return to a high level of performance as early as possible. Although lateral meniscectomy is known to have more serious long-term sequelae than medial meniscectomy, little is known about the effect of lateral meniscectomy on the time to return to play during the early recovery phase in professional soccer players.
Lateral meniscectomy results in longer times to return to preinjury level of competition and a higher incidence of adverse outcomes compared with medial meniscectomy in elite professional soccer players.
Cohort study; Level of evidence, 3.
A single-surgeon database containing the injury history and operative details of elite soccer athletes from 2005 to 2009 was used to identify players who had undergone an isolated partial lateral or medial meniscectomy. The time to return to preinjury level of competition, the incidence of adverse events during early recovery, and the need for further arthroscopy were recorded. Time to return to play was analyzed by using the Kaplan-Meier method. A multivariate analysis was used to control for age, location of meniscectomy, percentage of meniscus excised, and type of tear.
Ninety soccer players were identified, of which 42 had a lateral meniscectomy and 48 had a medial meniscectomy. The median time to return to play, to the nearest week, was longer in the lateral group than the medial group (7 vs 5; P < .001). At all time points after surgery, the cumulative probability of returning to play was 5.99 times greater (95% confidence interval, 3.34-10.74; P < .001) after medial meniscectomy. More lateral meniscectomy cases experienced adverse events related to pain/swelling-29 (69%) vs 4 (8%) (P < .001)-and required a second arthroscopy: 3 (7%) vs 0 (P = .098).
The time to return to preinjury level of competition is significantly longer after lateral than medial meniscectomy in elite professional soccer athletes. Lateral meniscectomy has a higher incidence of adverse events in the early recovery period, including pain/swelling and the need for further arthroscopy. It is also associated with a significantly lower rate of return to play. These findings form the basis of an important discussion that must be had with player and club before a lateral meniscectomy is performed in elite soccer athletes.
在精英足球运动员中，半月板切除术经常被实施，以便他们能尽早恢复到高水平的竞技状态。虽然已知外侧半月板切除术比内侧半月板切除术有更严重的长期后遗症，但对于外侧半月板切除术对职业足球运动员早期恢复阶段重返赛场时间的影响却知之甚少。
在精英职业足球运动员中，与内侧半月板切除术相比，外侧半月板切除术导致恢复到伤前竞技水平的时间更长，且不良后果的发生率更高。
队列研究；证据等级，3级。
使用一个包含2005年至2009年精英足球运动员损伤史和手术细节的单外科医生数据库，来确定接受单纯部分外侧或内侧半月板切除术的运动员。记录恢复到伤前竞技水平的时间、早期恢复期间不良事件的发生率以及再次关节镜检查的必要性。使用Kaplan-Meier方法分析重返赛场的时间。采用多变量分析来控制年龄、半月板切除术的位置、切除半月板的百分比以及撕裂类型。
确定了90名足球运动员，其中42人接受了外侧半月板切除术，48人接受了内侧半月板切除术。外侧组恢复比赛的中位时间（精确到周）比内侧组长（7周对5周；P <.001）。在手术后的所有时间点，内侧半月板切除术后恢复比赛的累积概率高出5.99倍（95%置信区间，3.34 - 10.74；P <.001）。更多接受外侧半月板切除术的病例出现了与疼痛/肿胀相关的不良事件——29例（69%）对4例（8%）（P <.001）——并且需要再次关节镜检查：3例（7%）对0例（P =.098）。
在精英职业足球运动员中，外侧半月板切除术后恢复到伤前竞技水平的时间显著长于内侧半月板切除术。外侧半月板切除术在早期恢复阶段不良事件的发生率更高，包括疼痛/肿胀以及再次关节镜检查的必要性。它还与显著更低的重返赛场率相关。这些发现构成了在精英足球运动员进行外侧半月板切除术之前，必须与运动员和俱乐部进行重要讨论的基础。
