Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California.
Orthopaedic Institute for Children, UCLA, Los Angeles, California.
Sports Health. 2018 Jul-Aug;10(4):311-316. doi: 10.1177/1941738118768201. Epub 2018 Apr 12.
With the rise in sports participation and increased athleticism in the adolescent population, there is an ever-growing need to better understand adolescent meniscus pathology and treatment.
To better understand the operative management of meniscus tears in the adolescent population.
A systematic review of PubMed (MEDLINE) and Google Scholar was performed for all archived years.
Studies that reported on isolated meniscus tears in adolescent patients (age, 10-19 years) were included.
Systematic review and meta-analysis.
Level 4.
Two authors reviewed and extracted data from studies that fulfilled all inclusion criteria.
Nine studies on isolated meniscus tears in adolescent patients were found, with level of evidence ranging from 3 to 4. These studies evaluated a total of 373 patients (248 males, 125 females) and 390 knees. Seven studies were published between 1979 and 2000, all of which discuss meniscectomy as the primary treatment. Two studies were published after 2000 and report on meniscus repair surgery. The mean patient age was 14.4 years. A total of 308 meniscectomies and 64 meniscus repairs were performed. Follow-up ranged from 1.8 to 30 years (mean, 10.8 years). A 37% retear rate was reported for patients undergoing meniscus repair. Different outcome measures were used for meniscectomy versus meniscus repair. Three studies evaluating meniscectomy reported Tapper-Hoover scores, showing 54 patients with an excellent result, 58 with good, 57 with fair, and 23 with poor results.
A shift in the management of isolated adolescent meniscal tears is reflected in the literature, with a recent increase in operative repair. This is likely secondary to poor outcomes after meniscectomy reflected in long-term follow-up studies. The current literature highlights the need for improved description of tear patterns, standardized reporting of outcome measures, and improved study methodologies to help guide orthopaedic surgeons on operative treatment of meniscal tears in adolescent patients.
随着青少年参与体育运动的增加和运动能力的提高，人们越来越需要更好地了解青少年半月板的病理和治疗方法。
更好地了解青少年半月板撕裂的手术治疗方法。
对 PubMed（MEDLINE）和 Google Scholar 进行了系统的回顾，检索了所有存档年份的数据。
纳入了报告青少年患者（年龄 10-19 岁）孤立性半月板撕裂的研究。
系统评价和荟萃分析。
4 级。
两位作者对符合所有纳入标准的研究进行了回顾和数据提取。
共发现 9 项关于青少年患者孤立性半月板撕裂的研究，证据水平为 3 级至 4 级。这些研究共评估了 373 例患者（248 例男性，125 例女性）和 390 个膝关节。7 项研究发表于 1979 年至 2000 年之间，均讨论了半月板切除术作为主要治疗方法。有 2 项研究发表于 2000 年之后，报告了半月板修复手术。患者平均年龄为 14.4 岁。共进行了 308 例半月板切除术和 64 例半月板修复术。随访时间为 1.8 至 30 年（平均 10.8 年）。半月板修复术后的再撕裂率为 37%。半月板切除术和半月板修复术使用了不同的结果测量方法。3 项评估半月板切除术的研究报告了 Tapper-Hoover 评分，显示 54 例患者结果优秀，58 例良好，57 例一般，23 例较差。
文献中反映出青少年孤立性半月板撕裂的治疗方法发生了转变，手术修复的比例有所增加。这可能是由于长期随访研究中半月板切除术后结果不佳所致。目前的文献强调需要更好地描述撕裂模式，标准化报告结果测量方法，并改进研究方法，以帮助指导骨科医生对青少年半月板撕裂进行手术治疗。
