Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Knee Surg Sports Traumatol Arthrosc. 2020 Nov;28(11):3587-3596. doi: 10.1007/s00167-020-06287-9. Epub 2020 Sep 26.
The purpose of this study was to determine the outcomes of meniscus repair in the adolescent population, including: (1) failure and reoperation rates, (2) clinical and functional results, and (3) activity-related outcomes including return to sport.
Two authors independently searched MEDLINE, Cochrane Central Register of Controlled Trials & Cochrane Library, and CINHAL databases for literature related to meniscus repair in an adolescent population according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. No meta-analysis was performed in this qualitative systematic review.
Thirteen studies, including no Level I, one Level II, one Level III, and eleven Level IV studies yielded 466 patients with 503 meniscus repairs. All defined meniscal re-tear as a primary endpoint, with a reported failure rate ranging from 0 to 42% at a follow-up ranging from 22 to 211 months. There were a total of 93 failed repairs. IKDC scores were reported in four studies with a mean improvement ranging from 24 to 42 (P < 0.001). Mean post-operative Lysholm scores were reported in seven studies, ranging from 85 to 96. Additionally, four of those studies provided mean pre-operative Lysholm scores, ranging from 56 to 79, with statistically significant mean score improvements ranging from 17 to 31. Mean post-operative Tegner Activity scores were reported in nine studies, with mean values ranging from 6.2 to 8.
This systematic review demonstrates that both subjective and clinical outcomes, including failure rate, Lysholm, IKDC, and Tegner activity scale scores, are good to excellent following meniscal repair in the adolescent population. Further investigations should aim to isolate tear type, location, surgical technique, concomitant procedures, and rehabilitation protocols to overall rate of failure and clinical and functional outcomes.
IV.
本研究旨在确定青少年群体中半月板修复的结果，包括：（1）失败和再次手术率，（2）临床和功能结果，以及（3）与活动相关的结果，包括重返运动。
两位作者根据系统评价和荟萃分析的首选报告项目（PRISMA）指南，独立检索了 MEDLINE、Cochrane 对照试验注册中心和 CINHAL 数据库中与青少年人群半月板修复相关的文献。本定性系统评价未进行荟萃分析。
13 项研究，包括无 1 级、1 级、1 级、11 级 4 级研究，共纳入 466 例患者，503 例半月板修复。所有研究均将半月板再次撕裂定义为主要终点，在 22 至 211 个月的随访中，报告的失败率为 0 至 42%。共有 93 例修复失败。四项研究报告了 IKDC 评分，平均改善幅度从 24 到 42（P<0.001）。七项研究报告了平均术后 Lysholm 评分，范围从 85 到 96。此外，其中四项研究提供了平均术前 Lysholm 评分，范围从 56 到 79，平均得分改善幅度从 17 到 31。九项研究报告了平均术后 Tegner 活动评分，平均分值范围从 6.2 到 8。
本系统评价表明，青少年人群半月板修复后，主观和临床结果（包括失败率、Lysholm、IKDC 和 Tegner 活动量表评分）均良好至优秀。进一步的研究应旨在分离撕裂类型、位置、手术技术、伴随手术和康复方案，以确定总体失败率和临床及功能结果。
IV。
