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孤立性后内侧半月板根部修复术后不良事件和并发症的系统评价

A Systematic Review of Adverse Events and Complications After Isolated Posterior Medial Meniscus Root Repairs.

作者信息

Jackson Garrett R, Warrier Alec A, Wessels Morgan, Khan Zeeshan A, Obioha Obianuju, McCormick Johnathon R, Kaplan Daniel J, Mameri Enzo S, Knapik Derrick M, Verma Nikhil N, Chahla Jorge

机构信息

Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.

Instituto Brasil de Tecnologia da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil.

出版信息

Am J Sports Med. 2024 Mar;52(4):1109-1115. doi: 10.1177/03635465231157758. Epub 2023 May 2.

Abstract

BACKGROUND

Medial meniscus posterior root (MMPR) tears are recognized as a substantial cause of disability and morbidity. However, meniscus root repair, regardless of technique, is not without potential complications.

PURPOSE

To evaluate the reported incidence of complications and adverse events after isolated MMPR repair.

STUDY DESIGN

Systematic review; Level of evidence, 4.

METHODS

A systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using Embase, PubMed, and Scopus databases with the following search terms combined with Boolean operators: "meniscus,""root," and "repair." Inclusion criteria consisted of level 1 to 4 human clinical studies in English or English-language translation reporting complications and adverse events after isolated posterior medial meniscus root repairs. The overall incidence of specific complications was estimated from the pooled sample of the included studies.

RESULTS

Eleven studies with a total pooled sample of 442 patients were identified. The mean patient age was 58.1 years, while the mean final follow-up time was 37.2 months (range, 12-84.8 months). The overall incidence of complications was 9.7% (n = 43/442), with the most commonly reported complication being progressive degenerative changes within the knee (10.4%; n = 25/240; n = 5 studies). A total of 1.25% (n = 3/240) of patients who experienced degenerative changes required conversion to total knee arthroplasty. Repair failures were reported in 3.1% (n = 10/327; n = 8 studies) of patients.

CONCLUSION

Repairing MMPR tears is critical in preventing accelerated progression of knee osteoarthritis in patients without significant knee osteoarthritis preoperatively. While this repair is still recommended and necessary in appropriate patients, this review found that the incidence of complications after isolated posterior medial meniscus root repair was 9.7%, primarily involving the presence of progressive degeneration, while repair failure was reported in 3% of patients.

摘要

背景

内侧半月板后根(MMPR)撕裂被认为是导致残疾和发病的重要原因。然而,无论采用何种技术,半月板根部修复都并非没有潜在并发症。

目的

评估孤立性MMPR修复术后并发症和不良事件的报告发生率。

研究设计

系统评价;证据等级,4级。

方法

根据PRISMA(系统评价和Meta分析的首选报告项目)指南进行系统评价,使用Embase、PubMed和Scopus数据库,搜索词与布尔运算符组合如下:“半月板”“根部”和“修复”。纳入标准包括1至4级英文或英文翻译的人类临床研究,报告孤立性内侧半月板后根修复术后的并发症和不良事件。从纳入研究的汇总样本中估计特定并发症的总体发生率。

结果

共确定了11项研究,汇总样本总数为442例患者。患者平均年龄为58.1岁,平均最终随访时间为37.2个月(范围12 - 84.8个月)。并发症的总体发生率为9.7%(n = 43/442),最常报告的并发症是膝关节内进行性退变(10.4%;n = 25/240;n = 5项研究)。发生退变的患者中共有1.25%(n = 3/240)需要转换为全膝关节置换术。3.1%(n = 10/327;n = 8项研究)的患者报告修复失败。

结论

修复MMPR撕裂对于预防术前无明显膝关节骨关节炎患者的膝关节骨关节炎加速进展至关重要。虽然对于合适的患者仍推荐并需要进行这种修复,但本综述发现,孤立性内侧半月板后根修复术后并发症的发生率为9.7%,主要涉及进行性退变,3%的患者报告修复失败。

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