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孤立性半月板修复术后的特定运动结局:系统评价。

Sport-specific outcomes after isolated meniscal repair: a systematic review.

机构信息

Department of Orthopaedic and Trauma Surgery, Freiburg University Hospital, Hugstetter Str. 55, 79106, Freiburg, Germany.

OCM-Clinic, Steinerstr. 6, 81369, Munich, Germany.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2018 Mar;26(3):762-771. doi: 10.1007/s00167-017-4463-4. Epub 2017 Feb 27.

Abstract

PURPOSE

The purpose of this systematic review was to assess sport-specific outcomes after repair of isolated meniscal tears.

METHODS

A systematic electronic search of the MEDLINE and Cochrane database was performed in May 2016 to identify studies that reported sport-specific outcomes after isolated meniscal repair. Included studies were abstracted regarding study characteristics, patient demographics, surgical technique, rehabilitation, and outcome measures. The methodological quality of the included studies was assessed with the Coleman Methodology Score (CMS).

RESULTS

Twenty-eight studies with a total of 664 patients met the inclusion criteria. The methodological quality of the included studies was moderate, with a mean CMS of 69.7 ± 8.3. The mean patient age was 26 ± 7.2 years and 71% of patients were male. Mean preoperative Tegner score improved from 3.5 ± 0.3 to 6.2 ± 0.8 postoperatively. Comparing preinjury and postoperative Tegner scores, comparable values were observed (6.3 ± 1.1 and 5.7 ± 0.8, respectively). Return to sports on the preinjury level was achieved in 89%. Mixed-level populations returned to their preinjury activity level in 90% and professional athletes in 86%. Mean delay of return to sports varied between 4.3 and 6.5 months, with comparable results between professional and mixed-level athletes. The pooled failure rate was 21%. The failure rate was lower in professional athletes compared to mixed-level athletes (9% vs. 22%).

CONCLUSION

This systematic review suggests that isolated repair of meniscal tears results in good to excellent sport-specific outcomes and a high return to sports rate in both recreational and professional athletes. The failure rate is comparable to systematic reviews not focusing on sportive patients.

LEVEL OF EVIDENCE

Level IV systematic review of Level I to Level IV studies.

摘要

目的

本系统评价旨在评估单纯半月板撕裂修复后的运动特异性结果。

方法

2016 年 5 月,我们对 MEDLINE 和 Cochrane 数据库进行了系统电子检索,以确定报告单纯半月板修复后运动特异性结果的研究。纳入的研究被摘录,内容涉及研究特征、患者人口统计学、手术技术、康复和结果测量。使用 Coleman 方法学评分(CMS)评估纳入研究的方法学质量。

结果

28 项研究共纳入 664 例患者符合纳入标准。纳入研究的方法学质量中等,CMS 平均为 69.7±8.3。患者平均年龄为 26±7.2 岁,71%为男性。术前 Tegner 评分平均为 3.5±0.3,术后为 6.2±0.8。与术前相比,术后 Tegner 评分相似(分别为 6.3±1.1 和 5.7±0.8)。89%的患者恢复到受伤前的运动水平。混合水平的患者中有 90%恢复到受伤前的活动水平,专业运动员中有 86%恢复到受伤前的活动水平。重返运动的平均时间为 4.3 至 6.5 个月,专业运动员和混合水平运动员的结果相当。总的失败率为 21%。与混合水平运动员相比,专业运动员的失败率较低(9%比 22%)。

结论

本系统评价表明,单纯半月板撕裂修复可获得良好至优秀的运动特异性结果,在娱乐和专业运动员中,重返运动的比例较高。失败率与不专注于运动患者的系统评价相当。

证据等级

基于 I 级至 IV 级研究的 IV 级系统评价。

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