HERE, Sussex MSK Partnership, 5th Floor, 177 Preston Rd, Brighton BN1 6AG, UK.
HERE, Sussex MSK Partnership, 5th Floor, 177 Preston Rd, Brighton BN1 6AG, UK.
Knee. 2021 Dec;33:125-142. doi: 10.1016/j.knee.2021.08.035. Epub 2021 Oct 6.
Physiotherapy is indicated for treatment of a painful degenerative knee meniscus tear. Predicting the outcome remains uncertain.
The purpose of this systematic review was to identify which predictive factors are associated with the outcome of physiotherapy for degenerative knee meniscus tear.
A systematic electronic literature search was undertaken of PubMed, CINAHL, Medline with AMED and EMBASE via Ovid from inception to July 2021. Studies of adults receiving physiotherapy which presented data on the association of baseline variables and the treatment outcome were included. Study quality was assessed using CASP (Critical Appraisal Skills Programme) tools. Data were narratively analysed.
1051 titles were retrieved and screened for eligibility. Fifteen studies met the inclusion criteria. Nine studies investigated just degenerative tears. The evidence-base was of low/moderate quality. Across all studies, seven and five studies (100%) reported no association between mechanical symptoms or gender respectively (p > 0.05). There was no association with osteoarthritis in 80%, age in 71%, or body mass index in 60% of studies (p > 0.05). Four studies (80%) reported that higher baseline pain was associated with cross-over to surgery, greater improvement with surgery or less improvement in pain score (p > 0.05).
Patient demographic characteristics provide minimal association with outcome following physiotherapy for degenerative meniscus tear. The evidence-base is limited in size and quality. A large adequately powered prospective cohort study investigating a broad range of predictive factors is warranted to develop a predictive model to better stratify those most likely to benefit from physiotherapy.
物理疗法适用于治疗疼痛性退行性膝关节半月板撕裂。但预测其疗效仍不确定。
本系统综述旨在确定哪些预测因素与退行性膝关节半月板撕裂的物理治疗结果相关。
从建库至 2021 年 7 月，通过 Ovid 对 PubMed、CINAHL、Medline 与 AMED 和 EMBASE 进行了系统的电子文献检索。纳入了接受物理治疗并提供基线变量与治疗结果关联数据的成人研究。使用 CASP（批判性评估技能计划）工具评估研究质量。对数据进行了叙述性分析。
共检索到 1051 个标题并进行了筛选以确定其是否符合纳入标准。符合纳入标准的研究有 15 项。其中 9 项研究仅调查了退行性撕裂。证据基础的质量为低/中。在所有研究中，有 7 项和 5 项研究（100%）分别报告了机械症状或性别之间无关联（p>0.05）。80%的研究与骨关节炎无关，71%的研究与年龄无关，60%的研究与体重指数无关（p>0.05）。有 4 项研究（80%）报告称，基线疼痛较高与交叉手术相关，与手术相关的改善较大或疼痛评分改善较小（p>0.05）。
患者的人口统计学特征与退行性半月板撕裂的物理治疗结果相关性不大。证据基础在规模和质量上都有限。需要进行一项规模较大且具有充分效力的前瞻性队列研究，以调查广泛的预测因素，从而开发出一种预测模型，以便更好地对那些最有可能从物理治疗中受益的患者进行分层。
