Fong Francis Jia Yi, Ong Bryan Wei Loong, Lee Yee Han Dave
Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Department of Orthopaedic Surgery, National University of Singapore, Singapore.
Orthop J Sports Med. 2023 Mar 6;11(3):23259671231151698. doi: 10.1177/23259671231151698. eCollection 2023 Mar.
Medial meniscal extrusion (MME) has received significant interest because of its correlation with medial meniscus root tears (MMRTs), its potential as a diagnostic tool, and its significance in the progression of knee osteoarthritis (OA).
To (1) evaluate if MMRTs significantly increase MME compared with nonroot tears (NRTs) and no tears and (2) determine the clinical outcomes of increased MME.
Systematic review; Level of evidence, 4.
Electronic database searches of PubMed, Embase, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials were conducted on June 6, 2022, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist criteria. The searches were conducted using the keywords "meniscus tear" and "extrusion." No restrictions were placed on the date of publication. Quality and sensitivity assessments were conducted on included studies. Major MME was defined as an extrusion ≥3 mm.
Twenty-two studies involving 7882 knees were included. Compared with patients with NRTs, those with MMRTs had a 1.12-mm greater mean absolute meniscal extrusion (AME) and were 3.45 times more likely to have major MME ( < .001 for both). Compared with patients with no tears, those with MMRTs had a 2.13-mm greater AME ( < .001). Within patients with MMRT, those with widely displaced MMRT had a 1.01-mm greater AME compared with nondisplaced MMRT ( < .001). Patients with OA had a 0.73-mm greater AME and were 3.86 times more likely to have major MME compared with patients without OA ( < .001 for both). Within patients who were not stratified according to MMRT, NRT, or no tears, those who eventually developed OA had a 0.79-mm greater AME than those who did not have OA ( = .02).
Patients with MMRTs had higher MME values compared with those with other types of meniscal tears and those without any meniscal tears. Patients with knee OA were more likely to have higher MME compared with those without OA.
内侧半月板挤出（MME）因其与内侧半月板根部撕裂（MMRTs）的相关性、作为诊断工具的潜力以及在膝关节骨关节炎（OA）进展中的意义而受到广泛关注。
（1）评估与非根部撕裂（NRTs）和无撕裂相比，MMRTs是否会显著增加MME；（2）确定MME增加的临床结果。
系统评价；证据级别，4级。
根据系统评价和Meta分析的首选报告项目（PRISMA）2020清单标准，于2022年6月6日对PubMed、Embase、Scopus、Web of Science和Cochrane对照试验中央注册库进行了电子数据库检索。检索使用关键词“半月板撕裂”和“挤出”。对发表日期没有限制。对纳入的研究进行了质量和敏感性评估。主要MME定义为挤出≥3mm。
纳入了22项涉及7882个膝关节的研究。与NRTs患者相比，MMRTs患者的平均绝对半月板挤出（AME）大1.12mm，发生主要MME的可能性高3.45倍（两者均P<.001）。与无撕裂患者相比，MMRTs患者的AME大2.13mm（P<.001）。在MMRT患者中，广泛移位的MMRT患者的AME比未移位的MMRT患者大1.01mm（P<.001）。与无OA患者相比，OA患者的AME大0.73mm，发生主要MME的可能性高3.86倍（两者均P<.001）。在未根据MMRT、NRT或无撕裂进行分层的患者中，最终发展为OA的患者的AME比未患OA的患者大0.79mm（P=.02）。
与其他类型的半月板撕裂患者和无半月板撕裂患者相比，MMRTs患者的MME值更高。与无OA的患者相比，膝关节OA患者更有可能具有更高的MME。
