Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, Missouri, USA.
Am J Sports Med. 2022 Jul;50(9):2367-2373. doi: 10.1177/03635465221098141. Epub 2022 Jun 1.
Meniscal pathology is commonly encountered in the setting of anterior cruciate ligament (ACL) rupture and is increasingly common in the pediatric and adolescent population. Studies have shown that over half of individuals presenting with ACL rupture will have concurrent meniscal pathology.
To define trends in the utilization of meniscal procedures (ie, meniscus repair vs partial meniscectomy) and short-term complications in pediatric and young adult patients with meniscal pathology in the setting of a concurrent ACL reconstruction.
Cohort study; Level of evidence, 3.
The IBM MarketScan Commercial Database was utilized to identify ACL reconstruction procedures performed between 2006 and 2018 for individuals aged 5 to 30 years. Annual proportions of meniscectomy and meniscal repair were analyzed, and short-term complications were compared between pediatric/adolescent patients (aged 5-17 years) and young adults (aged 18-30 years).
An overall 40,736 records of individuals <18 years old with ACL tears were included. The pediatric/adolescent population had a significantly lower proportion of concomitant meniscal procedures (56.8%; 23,149/40,736) than the young adult population (59.7%; 33,764/56,515; < .01). From 2006 to 2018, utilization of meniscal repair in the setting of ACL reconstruction steadily increased (20.1% to 35.1% [+15 percentage points], < .01), while the proportion with meniscectomy decreased (34.4% to 21.3% [-13.1 percentage points], < .01). There was no difference in rate of reoperation for repeat meniscal repair or meniscectomy in the pediatric/adolescent population for those undergoing meniscal repair versus meniscectomy within 180 days of primary surgery (1.7% [188/10,766] vs 1.5% [186/12,383]; = .14).
From 2006 to 2018, the proportion of patients receiving ACL reconstruction with concomitant meniscal repair increased (20.1% to 35.1%) while the proportion with meniscectomy decreased (34.4% to 21.3%) in the pediatric/adolescent population. Meniscal repair was not associated with a higher 180-day rate of reoperation for repeat meniscal repair or meniscectomy than meniscectomy in the setting of ACL reconstruction.
半月板病变在前交叉韧带（ACL）断裂的情况下很常见，在儿童和青少年人群中越来越常见。研究表明，超过一半的 ACL 断裂患者会同时存在半月板病变。
定义在同时进行 ACL 重建的情况下，伴发半月板病变的儿童和年轻成人患者中半月板手术（半月板修复与部分半月板切除术）的使用趋势和短期并发症。
队列研究；证据水平，3 级。
利用 IBM MarketScan 商业数据库，确定了 2006 年至 2018 年间年龄在 5 至 30 岁之间接受 ACL 重建手术的患者。分析了半月板切除术和半月板修复术的年度比例，并比较了儿科/青少年患者（5-17 岁）和年轻成人患者（18-30 岁）之间的短期并发症。
共纳入 40736 例年龄<18 岁的 ACL 撕裂患者。儿科/青少年人群中同时进行半月板手术的比例明显低于年轻成人人群（56.8%，23149/40736；<0.01）。2006 年至 2018 年间，ACL 重建中半月板修复的使用率稳步上升（20.1%至 35.1%[+15 个百分点]，<0.01），而半月板切除术的比例下降（34.4%至 21.3%[-13.1 个百分点]，<0.01）。在初次手术后 180 天内接受半月板修复术或半月板切除术的儿童/青少年患者中，再次行半月板修复术或半月板切除术的再手术率无差异（1.7%[188/10766]与 1.5%[186/12383]；=0.14）。
2006 年至 2018 年间，在儿科/青少年人群中，接受 ACL 重建伴半月板修复的患者比例增加（20.1%至 35.1%），而接受半月板切除术的患者比例下降（34.4%至 21.3%）。在 ACL 重建中，半月板修复术并不比半月板切除术在 180 天内再次行半月板修复术或半月板切除术的发生率更高。
