From the UBMD Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY.
J Am Acad Orthop Surg Glob Res Rev. 2024 Sep 25;8(9). doi: 10.5435/JAAOSGlobal-D-23-00293. eCollection 2024 Sep 1.
This study aimed to (1) compare patient-reported outcome measures between patients who underwent medial meniscus root tear (MMRT) repair and those who underwent other types of medial meniscus repair, and (2) identify factors associated with observed differences.
A literature search identified studies reporting PROMs-knee injury and osteoarthritis outcome score (KOOS) or visual analog scale (VAS) for pain-after repair of the medial meniscus. Studies were excluded if outcomes were not separated by tear type or reported graphically, different or no outcomes reported, no repair or repair with a sutureless method, follow-up greater than 72 months, case report, and systematic review. Patient-reported outcome measures and demographics were summarized as sample-weighted means and compared using t-tests. Mixed model linear regressions were fit predicting postoperative PROMs adjusted for tear type, preoperative PROMs, and follow-up time. F statistics of type III tests of fixed effects were compared.
Eighteen articles were included, n = 10 received MMRT repair and n = 8 other tear repairs. Postoperative values for all KOOS scores were less for the MMRT repair group compared with the other tear repair group, VAS pain was not statistically different. Tear type was a stronger predictor for postoperative PROMs than the preoperative score and duration of follow-up for all KOOS scores, but not VAS pain. On average, the MMRT repair group had shorter follow-up, more women, older age, and greater BMI.
All postoperative PROMs except for VAS pain were worse for patients who underwent MMRT repair compared with patients who underwent other types of medial meniscus repair. Tear type was a better predictor of postoperative PROMs despite intergroup differences in preoperative PROMs and duration of follow-up. Relative risk factors for MMRT compared with other types of medial meniscus tears include older age, greater BMI, and female sex.
本研究旨在：（1）比较内侧半月板后根部撕裂（MMRT）修复与其他内侧半月板修复患者的患者报告结局测量值；（2）确定与观察到的差异相关的因素。
文献检索确定了报告内侧半月板修复后患者报告结局测量值（膝关节损伤和骨关节炎结局评分（KOOS）或疼痛视觉模拟量表（VAS））的研究。如果结局未按撕裂类型分离或以图形方式报告、报告了不同或无结局、未进行修复或采用无缝线修复方法、随访时间超过 72 个月、病例报告或系统评价，则排除研究。患者报告结局测量值和人口统计学数据总结为样本加权均值，并使用 t 检验进行比较。使用混合模型线性回归预测术后 PROM，调整撕裂类型、术前 PROM 和随访时间。比较固定效应的 III 型检验的 F 统计量。
纳入 18 篇文章，n = 10 例接受 MMRT 修复，n = 8 例接受其他撕裂修复。与其他撕裂修复组相比，所有 KOOS 评分的术后值在 MMRT 修复组中均较低，VAS 疼痛无统计学差异。撕裂类型是所有 KOOS 评分术后 PROM 的预测因素强于术前评分和随访时间，而不是 VAS 疼痛。平均而言，MMRT 修复组的随访时间较短、女性更多、年龄较大、BMI 较高。
与接受其他类型内侧半月板修复的患者相比，接受 MMRT 修复的患者的所有术后 PROM 除了 VAS 疼痛外均较差。尽管组间存在术前 PROM 和随访时间的差异，但撕裂类型仍是术后 PROM 的更好预测因素。与其他类型内侧半月板撕裂相比，MMRT 的相对危险因素包括年龄较大、BMI 较高和女性。
