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半月板移植后可行低影响运动活动:系统评价。

Low-impact sports activities are feasible after meniscus transplantation: a systematic review.

机构信息

The Noyes Knee Institute, Cincinnati Sportsmedicine and Orthopaedic Center, The Jewish Hospital-Mercy Health, 10663 Montgomery Rd., Cincinnati, OH, 45242, USA.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2018 Jul;26(7):1950-1958. doi: 10.1007/s00167-017-4658-8. Epub 2017 Jul 27.

Abstract

PURPOSE

To determine sports activities achieved after meniscus transplantation and if associations exist between sports activity levels and transplant failure or progression of tibiofemoral osteoarthritis (OA).

METHODS

A systematic search was performed using PubMed and Cochrane online databases. Inclusionary criteria were English language, clinical trials published from 1996 through May 2017, minimum 2 years of follow-up, and sports activity data reported.

RESULTS

Twenty-eight studies were included in which 1521 menisci were implanted into 1497 patients. The mean age was 34.3 ± 6.7 years, and the mean follow-up was 5.0 ± 3.7 years. Details on sports activities were provided in 7 studies (285 patients) that reported 70-92% of patients returned to a wide variety of sports activities. Mean Tegner activity scores were reported in 24 investigations. The mean score was <5 in 58% of these studies, indicating many patients were participating in light recreational activities. There was no association between mean Tegner scores and transplant failure rates. A moderate correlation was found between failure rates and mean follow-up time (R = 0.63). The effect of sports activity levels on progression of tibiofemoral OA could not be determined because of limited data. Only two studies determined whether symptoms occurred during sports activities; these reported 1/38 (3%) and 5/69 (7%) patients had knee-related problems.

CONCLUSIONS

It appeared that the majority of individuals returned to low-impact athletic activities after meniscus transplantation. The short-term follow-up did not allow for an analysis on the effect of return to high-impact activities on transplant failure rates or progression of OA.

LEVEL OF EVIDENCE

IV.

摘要

目的

确定半月板移植后患者能够进行的运动活动,并分析运动活动水平与移植失败或膝关节进展性骨关节炎(OA)之间是否存在关联。

方法

系统检索了 PubMed 和 Cochrane 在线数据库,纳入标准为 1996 年 5 月至 2017 年发表的英语临床研究,随访时间至少 2 年,且报告了运动活动数据。

结果

共纳入 28 项研究,1521 个半月板植入 1497 例患者。平均年龄为 34.3±6.7 岁,平均随访时间为 5.0±3.7 年。有 7 项研究(285 例患者)详细报告了运动活动情况,报道称 70%~92%的患者恢复了各种运动活动。24 项研究报告了平均 Tegner 活动评分,其中 58%的研究平均评分为<5,表明许多患者参与了轻度娱乐性活动。Tegner 评分平均值与移植失败率之间无相关性。在中等随访时间(R=0.63)的情况下,发现失败率与平均随访时间之间存在中度相关性。由于数据有限,无法确定运动活动水平对膝关节进展性 OA 的影响。只有 2 项研究确定了运动活动中是否出现症状,分别有 1/38(3%)和 5/69(7%)的患者出现膝关节相关问题。

结论

半月板移植后,大多数患者似乎可以恢复低冲击性运动活动。短期随访未分析重返高冲击性活动对移植失败率或 OA 进展的影响。

证据等级

IV。

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