School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece; Thessaloniki Minimally Invasive (The-MIS) Orthopaedic Center, St. Luke's Hospital, Thessaloniki, Greece.
Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, USA.
Arthroscopy. 2021 Jul;37(7):2351-2360. doi: 10.1016/j.arthro.2021.02.046. Epub 2021 Mar 19.
To systematically review the literature of return-to-sport outcomes following all-inside meniscus repair and evaluate whether concomitant anterior cruciate ligament reconstruction (ACLR) influenced these outcomes.
A systematic review of the MEDLINE, PubMed, Embase, and Cochrane Registry of Systematic Reviews databases was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two reviewers examined all literature pertaining to sport outcomes following all-inside meniscal repair. Studies were included if they had a 12-month minimum follow-up and reported return to sport rate, Tegner, or Knee injury and Osteoarthritis Outcome Score (KOOS) Sport outcomes. Studies with meniscal repair techniques other than the all-inside technique were excluded. Studies were not excluded if they contained patients receiving concomitant ACLR. Study quality was evaluated with the Methodological Index for Nonrandomized Studies.
Nineteen studies comprising 872 patients were included in this investigation. The weighted average patient age was 28.7 (range 14.1-42.1) years, and the weighted average follow-up was 56.0 (range 18.0-155.0) months. The mean Methodological Index for Nonrandomized Studies score was 14.4 ± 3.7. Ten investigations reported both preoperative (range 2.3-3.5) and postoperative (range 4.0-7.3) Tegner outcomes, with scores at final follow-up greater in each of the 10 reporting investigations. KOOS Sport outcomes were examined in 5 investigations, with scores at follow-up ranging from 63.6 to 91. Three studies reported a return to sport rate ranging from 89.6 to 90% at follow-up. Four investigations compared sport-related outcomes between isolated meniscal repair and meniscal repair with concomitant ACLR. Two such studies reported no difference between the 2 cohorts, 1 favored the isolated cohort, and 1 favored the combined cohort.
This systematic review found a 90% return-to-sport rate and high postoperative activity level following all-inside meniscal repair, as assessed by KOOS Sport and Tegner activity scales. Further, concurrent ACLR did not significantly affect these outcomes.
IV, systematic review of level I-IV studies.
系统回顾全内半月板修复术后重返运动的文献，并评估是否同时行前交叉韧带重建（ACLR）会影响这些结果。
根据系统评价和荟萃分析的首选报告项目，对 MEDLINE、PubMed、Embase 和 Cochrane 系统评价登记处进行了系统评价。两位审阅者检查了所有与全内半月板修复后运动结果相关的文献。如果研究有至少 12 个月的随访并报告了重返运动率、Tegner 或膝关节损伤和骨关节炎结果评分（KOOS）运动结果，则将其纳入研究。排除了使用全内技术以外的半月板修复技术的研究。如果包含同时接受 ACLR 的患者，也不会排除这些研究。使用非随机研究方法学指数评估研究质量。
这项研究共纳入了 19 项研究，共 872 例患者。加权平均患者年龄为 28.7 岁（范围 14.1-42.1 岁），加权平均随访时间为 56.0 个月（范围 18.0-155.0 个月）。非随机研究方法学指数的平均得分是 14.4±3.7。有 10 项研究报告了术前（范围 2.3-3.5）和术后（范围 4.0-7.3）的 Tegner 评分，在 10 项报告研究中，最终随访时的评分均更高。有 5 项研究检查了 KOOS 运动结果，随访时的评分范围从 63.6 到 91。有 3 项研究报告了随访时 89.6%至 90%的重返运动率。有 4 项研究比较了单纯半月板修复与半月板修复联合 ACLR 的运动相关结果。有 2 项此类研究报告 2 个队列之间没有差异，1 项研究倾向于单纯队列，1 项研究倾向于联合队列。
这项系统评价发现，在全内半月板修复术后，90%的患者重返运动，根据 KOOS 运动和 Tegner 活动量表评估，术后活动水平较高。此外，同时行 ACLR 并不会显著影响这些结果。
IV，对 I-IV 级研究的系统评价。
