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关于半月板修复后长期结果的系统评价。

A systematic review about long-term results after meniscus repair.

机构信息

Klinik Für Orthopädie und Unfallchirurgie, Martin Luther Krankenhaus, Berlin, Grunewald, Caspar Theyss Strasse 27-31, 14193, Berlin, Germany.

Orthopädische Gemeinschaftspraxis Neuss (OPN), Neuss, Germany.

出版信息

Arch Orthop Trauma Surg. 2022 May;142(5):835-844. doi: 10.1007/s00402-021-03906-z. Epub 2021 Apr 28.

Abstract

PURPOSE

Aim of this systematic review was to analyze long-term results after meniscus refixation.

METHODS

A systematic literature search was carried out in various databases on studies on long-term results after meniscus refixation with a minimum follow-up of 7 years. Primary outcome criterion was the failure rate. Secondary outcome criteria were radiological signs of osteoarthritis (OA) and clinical scores.

RESULTS

A total of 12 retrospective case series (level 4 evidence) were identified that reported about failure rates of more than 7 years follow-up. There was no statistical difference in the failure rates between open repair, arthroscopic inside-out with posterior incisions and arthroscopic all-inside repair with flexible non-resorbable implants. In long-term studies that examined meniscal repair in children and adolescents, failure rates were significantly higher than in studies that examined adults. Six studies have shown minor radiological degenerative changes that differ little from the opposite side. The reported clinical scores at follow-up were good to very good.

CONCLUSION

This systematic review demonstrates that good long-term outcomes can be obtained in patients after isolated meniscal repair and in combination with ACL reconstruction. With regard to the chondroprotective effect of meniscus repair, the long-term failure rate is acceptable.

LEVEL OF EVIDENCE

IV.

摘要

目的

本系统评价旨在分析半月板缝合固定后的长期结果。

方法

在多个数据库中进行了系统文献检索,以检索半月板缝合固定后至少随访 7 年的长期结果研究。主要结局标准为失败率。次要结局标准为骨关节炎(OA)的放射学征象和临床评分。

结果

共确定了 12 项回顾性病例系列研究(4 级证据),这些研究报告了超过 7 年的随访失败率。开放性修复、关节镜下后入路关节内缝合和关节镜下全内缝合用可弯曲不可吸收植入物的修复的失败率无统计学差异。在检查儿童和青少年半月板修复的长期研究中,失败率明显高于检查成年人的研究。有 6 项研究显示出轻微的放射学退行性改变,与对侧相比差异很小。随访时报告的临床评分良好至非常好。

结论

本系统评价表明,在单独半月板修复以及与 ACL 重建相结合的患者中,可获得良好的长期结果。就半月板修复的软骨保护作用而言,长期失败率是可以接受的。

证据等级

IV。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faad/8994714/8ff33dd4930f/402_2021_3906_Fig1_HTML.jpg

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