Farinelli Luca, Meena Amit, Montini Davide, Patralekh Mohit Kumar, Piritore Giuseppe, Grassi Marco, Gigante Antonio, Hoser Christian, Fink Christian, Tapasvi Sachin
Clinical Orthopedics, Department of Clinical and Molecular sciences, Università Politecnica delle Marche, Ancona, Italy.
Division of Orthopedics, Shalby Multi-Specialty Hospital, Jaipur, India.
Knee Surg Sports Traumatol Arthrosc. 2025 Apr;33(4):1333-1344. doi: 10.1002/ksa.12441. Epub 2024 Aug 27.
The present meta-analysis aims to determine the outcomes and failure rates for medial meniscus repairs in patients with stable knees.
A literature search was conducted using PubMed and Scopus with the terms '(medial meniscus OR medial meniscal) AND (repair)'. The search strategy was based on the PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) protocol and included 93 articles assessed for eligibility. The search criteria were limited to studies reporting outcomes and failure rates. The exclusion criteria included languages other than English, biomechanical studies, letters to editors, non-full text, review articles, meta-analyses and case reports.
In total, 10 studies with 595 patients were included. Degenerative tears or studies reporting meniscus repair outcomes on root repairs, revision or primary anterior cruciate ligament reconstruction, discoid menisci or ramp lesions were excluded. All studies included revision surgery and/or clinical symptoms as failure definitions. The overall medial meniscal repair failure rate was 26% with a 95% confidence interval (CI) [15%-37%]. The mean time to failure from isolated medial meniscus repair surgery was 27.7 months with 95% CI [18.5-36.9 months]. The postoperative Lysholm and IKDC scores were reported in three articles. At the final follow-up, the mean postoperative Lysholm and IKDC scores were 92.3 with 95% CI [84.5-100] and 88.6 with 95% CI [83.5-93.8], respectively.
The current meta-analysis revealed an overall failure rate of 26% in the case of medial meniscus repair in a stable knee. For these reasons, the patient should be aware of the substantial risk of revision surgery (one out of four cases). Medial meniscus repair in a stable knee yielded good clinical results.
Level II.
本荟萃分析旨在确定膝关节稳定患者内侧半月板修复的结果及失败率。
使用PubMed和Scopus数据库，以“(内侧半月板或内侧半月板的) AND (修复)”为检索词进行文献检索。检索策略基于PRISMA（系统评价和荟萃分析的首选报告项目）方案，共纳入93篇文章进行资格评估。检索标准仅限于报告结果和失败率的研究。排除标准包括非英文文献、生物力学研究、给编辑的信件、非全文、综述文章、荟萃分析和病例报告。
共纳入10项研究，涉及595例患者。排除了退行性撕裂或报告半月板根部修复、翻修或初次前交叉韧带重建、盘状半月板或斜坡损伤修复结果的研究。所有研究均将翻修手术和/或临床症状作为失败的定义。内侧半月板修复的总体失败率为26%，95%置信区间（CI）为[15%-37%]。单纯内侧半月板修复手术后的平均失败时间为27.7个月，95%CI为[18.5-36.9个月]。三篇文章报告了术后Lysholm和IKDC评分。在最后随访时，术后Lysholm和IKDC评分的平均值分别为92.3（95%CI [84.5-100]）和88.6（95%CI [83.5-93.8]）。
当前的荟萃分析显示，膝关节稳定患者内侧半月板修复的总体失败率为26%。因此，患者应意识到翻修手术的重大风险（四分之一的病例）。膝关节稳定患者的内侧半月板修复取得了良好的临床效果。
二级。
