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关节镜下半月板修复的疗效及长期预后:一项系统评价与荟萃分析

Efficacy and Long-Term Outcomes of Arthroscopic Meniscus Repair: A Systematic Review and Meta-Analysis.

作者信息

Chand Siddharth Babu, Santhosh Gayathry, Saseendran Aravind, Gopinath Abhilash V, Chand Goutham B, Viswambharan Varsha, Gowda Gb Abhishek, Rao Chetana

机构信息

Department of Orthopaedics, Sree Narayana Institute of Medical Sciences, Kunnukara, IND.

Department of General Surgery, Doctor's Hospital, Ernakulam, IND.

出版信息

Cureus. 2024 Oct 4;16(10):e70828. doi: 10.7759/cureus.70828. eCollection 2024 Oct.

Abstract

The objective of this systematic review and meta-analysis was to evaluate the efficacy and long-term outcomes of arthroscopic meniscus repair, focusing on success, failure, and reoperation rates. A comprehensive literature search was conducted across PubMed, EMBASE, Cochrane Library, and Scopus, including studies that involved patients undergoing arthroscopic meniscus repair with a minimum follow-up of two years. The quality of the included studies was assessed using the Cochrane Risk of Bias Tool for randomized controlled trials and the Newcastle-Ottawa Scale for observational studies. Meta-analyses were conducted using RStudio 4.3.1 software (RStudio Inc., Boston, MA), with pooled risk ratios (RR) and 95% confidence intervals (CIs) calculated for dichotomous outcomes using a random effects model. The meta-analysis included 10 studies totaling 1,004 patients. The pooled success rate for arthroscopic meniscus repair was 83% (95% CI: 77%-89%), while the pooled failure rate was 20% (95% CI: 15%-25%), and the pooled reoperation rate was 21% (95% CI: 17%-25%). Significant heterogeneity was observed across studies (I² > 50%). Subgroup analyses based on suture techniques and concurrent anterior cruciate ligament (ACL) reconstruction did not reveal significant outcome differences. Arthroscopic meniscus repair demonstrates high success rates and acceptable failure and reoperation rates, supporting its continued use in clinical practice. However, the variability in study quality and significant heterogeneity highlight the need for more rigorous, high-quality studies to refine techniques and better explore long-term outcomes.

摘要

本系统评价和荟萃分析的目的是评估关节镜下半月板修复的疗效和长期预后,重点关注成功率、失败率和再次手术率。通过检索PubMed、EMBASE、Cochrane图书馆和Scopus进行了全面的文献搜索,纳入的研究包括对接受关节镜下半月板修复且至少随访两年的患者进行的研究。使用Cochrane随机对照试验偏倚风险工具和纽卡斯尔-渥太华量表对纳入研究的质量进行评估。使用RStudio 4.3.1软件(RStudio公司,马萨诸塞州波士顿)进行荟萃分析,采用随机效应模型计算二分结果的合并风险比(RR)和95%置信区间(CI)。荟萃分析纳入了10项研究,共1004例患者。关节镜下半月板修复的合并成功率为83%(95%CI:77%-89%),合并失败率为20%(95%CI:15%-25%),合并再次手术率为21%(95%CI:17%-25%)。各研究间观察到显著的异质性(I²>50%)。基于缝合技术和同期前交叉韧带(ACL)重建的亚组分析未显示出显著的结果差异。关节镜下半月板修复显示出较高的成功率以及可接受的失败率和再次手术率,支持其在临床实践中的持续应用。然而,研究质量的差异和显著的异质性凸显了需要更严格、高质量的研究来改进技术并更好地探索长期预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d25b/11531707/35665c70136c/cureus-0016-00000070828-i01.jpg

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