Myers Peter, Tudor Francois
Brisbane Orthopaedic & Sports Medicine Centre, Brisbane, Queensland, Australia.
Brisbane Orthopaedic & Sports Medicine Centre, Brisbane, Queensland, Australia.
Arthroscopy. 2015 May;31(5):911-25. doi: 10.1016/j.arthro.2014.11.020. Epub 2015 Jan 14.
We undertook a systematic review to assess a number of the technical aspects of meniscal allograft transplantation (MAT) that have not been covered in other reviews. Specific variables studied included the indications for MAT, graft fixation method, rehabilitation protocols, outcome scores, and definition of failure.
We performed a systematic literature review of the PubMed, EMBASE, and Cochrane databases to determine the outcomes of meniscal transplantation at greater than 2 years postoperatively. PRISMA (Preferred Reporting for Systematic Reviews and Meta-Analyses) guidelines were followed with a PRISMA checklist. The search was completed on January 5, 2014.
These queries returned 629 results from which 41 articles were identified as meeting the inclusion criteria. No studies in this review were randomized or controlled.
MAT is a worthwhile procedure, with evidence that it provides pain relief and improved function, and good results reported in mid- to long-term studies. The procedure should be considered only in a patient with localized pain and a stable (or stabilized) and well-aligned (or realigned) knee. The controversial areas studied in this review include the following: there is no evidence to support fixation with either bone plugs or soft tissue; there is no standardized rehabilitation program, but it appears that full weight bearing by 6 weeks is not detrimental; and a clear and uniform definition of failure and use of consistent outcome scores would aid future reporting and analysis of the results of meniscal transplantation.
Level IV, systematic review of Level II to IV studies.
我们进行了一项系统评价，以评估半月板同种异体移植（MAT）的一些技术方面，这些方面在其他综述中尚未涉及。研究的具体变量包括MAT的适应证、移植物固定方法、康复方案、结果评分以及失败的定义。
我们对PubMed、EMBASE和Cochrane数据库进行了系统的文献综述，以确定术后2年以上半月板移植的结果。遵循PRISMA（系统评价和Meta分析的首选报告）指南，并使用PRISMA清单。检索于2014年1月5日完成。
这些检索返回了629条结果，其中41篇文章被确定符合纳入标准。本综述中没有随机或对照研究。
MAT是一种值得实施的手术，有证据表明它能缓解疼痛并改善功能，且中长期研究报告了良好的结果。该手术仅应考虑用于有局部疼痛且膝关节稳定（或已稳定）和对线良好（或已重新对线）的患者。本综述中研究的有争议领域包括：没有证据支持使用骨栓或软组织进行固定；没有标准化的康复方案，但似乎术后6周完全负重并无坏处；明确统一的失败定义以及使用一致的结果评分将有助于未来半月板移植结果的报告和分析。
IV级，对II至IV级研究的系统评价。
