与退行性病变相比，关节镜下对稳定膝关节进行部分半月板切除术治疗创伤性撕裂的长期临床和影像学结果更好：一项系统评价。
Long-term clinical and radiological outcomes after arthroscopic partial meniscectomy on stable knees are better for traumatic tears when compared to degenerative lesions: A systematic review.
作者信息
Bogas Droy Héloïse, Dardenne Théopol, Djebara Azeddine, Pujol Nicolas
机构信息
Department of Orthopaedic, Centre Hospitalier Universitaire de Bordeaux, Hospital Pellegrin, Bordeaux, France.
Department of Orthopaedic, Centre Hospitalier de Versailles, Le Chesnay, France.
出版信息
Knee Surg Sports Traumatol Arthrosc. 2025 Jan;33(1):107-123. doi: 10.1002/ksa.12329. Epub 2024 Jun 21.
PURPOSE
An arthroscopic partial meniscectomy (APM) for degenerative meniscus lesions and traumatic meniscus tears are two distinct entities and their long-term outcomes are rarely reported. The aim of this review was to compare the long-term (clinical and radiological) results of APM performed on stable knees for traumatic tears (TT) or degenerative lesions (DL).
METHODS
Pubmed, Scopus and Embase databases were searched to identify relevant studies published between 2010 and 2023 using the keywords 'meniscectomy' OR 'meniscectomies' OR 'meniscal resection'. English-language, Levels I-IV evidence studies reporting either radiographic or clinical outcome measures with a minimum of 6 years' follow-up after APM were included. Studies including discoid meniscus, open meniscectomy, unstable knee and combination with other procedures were excluded. To rate the quality of evidence, the methodological index for non-randomized studies was used.
RESULTS
Thirty-two studies were included, with follow-up periods ranging from 6 to 22 years. Eleven studies dealt with TT with a mean age of 31.5 ± 6.6 years and a mean follow-up of 11.6 ± 6.9 years. At the last follow-up, radiographic osteoarthritis (OA) ranged from 36% to 76%, with an average rate of 48 ± 19%; functional scores ranged from 71 to 97, with a mean of 90 ± 4 for the Lysholm score, 86 ± 10 for the International Knee Documentation Committee (IKDC) and 94 ± 16 for the knee injury and osteoarthritis outcome (KOOS). Twenty-one studies dealt with DL with a mean age of 49.9 ± 7.2 years and a mean follow-up of 14.9 ± 6.3 years. At the last follow-up, radiographic OA ranged from 23% to 97%, with an average rate of 77 ± 28%; functional scores ranged from 40 to 87, with a mean of 79 ± 10 for the Lysholm score and 71 ± 16 for the IKDC.
CONCLUSION
Ten-year clinical outcomes of APM are better for TTs when compared to DLs. Rates of OA are difficult to compare but lower for TTs.
LEVEL OF EVIDENCE
Level IV.
目的
关节镜下部分半月板切除术（APM）用于治疗退行性半月板损伤和创伤性半月板撕裂是两种不同的情况，其长期疗效鲜有报道。本综述的目的是比较在稳定膝关节上针对创伤性撕裂（TT）或退行性病变（DL）进行APM的长期（临床和影像学）结果。
方法
检索PubMed、Scopus和Embase数据库，以识别2010年至2023年间发表的相关研究，使用关键词“半月板切除术”或“半月板切除术”或“半月板切除”。纳入英语、I-IV级证据的研究，这些研究报告了APM后至少6年随访的影像学或临床结局指标。排除包括盘状半月板、开放性半月板切除术、不稳定膝关节以及与其他手术联合的研究。为评估证据质量，使用了非随机研究的方法学指标。
结果
纳入32项研究，随访期为6至22年。11项研究涉及TT，平均年龄为31.5±6.6岁，平均随访11.6±6.9年。在最后一次随访时，影像学骨关节炎（OA）发生率为36%至76%，平均发生率为48±19%；功能评分范围为71至97，Lysholm评分为90±4，国际膝关节文献委员会（IKDC）评分为86±10，膝关节损伤和骨关节炎结局（KOOS）评分为94±16。21项研究涉及DL，平均年龄为49.9±7.2岁，平均随访14.9±6.3年。在最后一次随访时，影像学OA发生率为23%至97%，平均发生率为77±28%；功能评分范围为40至87，Lysholm评分为79±10，IKDC评分为71±16。
结论
与DL相比，APM治疗TT的十年临床结局更好。OA发生率难以比较，但TT的发生率较低。
证据级别
IV级。
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