Tsakiri Vasiliki, Kyriakidis Theofylaktos, Papadopoulos Polychronis, Davitis Vasileios, Chalidis Byron, Papadopoulos Periklis, Gigis Ioannis
2nd Orthopaedic Department, General Hospital "G. Gennimatas" Aristotle University of Thessaloniki, Thessaloniki, GRC.
School of Medicine, 1st Orthopaedic Department, Aristotle University of Thessaloniki, Thessaloniki, GRC.
Cureus. 2025 Mar 28;17(3):e81329. doi: 10.7759/cureus.81329. eCollection 2025 Mar.
Bucket-handle tears represent a subtype of meniscal injuries that involve a full-thickness longitudinal tear. These tears are challenging and demanding. The present systematic review and meta-analysis aimed to evaluate return-to-sport outcomes in young adults with isolated bucket-handle meniscal tears treated surgically through meniscal repair. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with two independent reviewers selecting studies from PubMed, Web of Science, and Scopus databases. Studies were included if they involved patients over 16 years old, with isolated bucket-handle tears, a minimum of one-year follow-up, and reported postoperative Tegner scores. Five studies comprising 168 individual knees met these criteria and were analyzed. Quality assessment employed the Newcastle-Ottawa Scale. Data analysis was conducted in R (R Foundation for Statistical Computing, Vienna, Austria) for pooled outcome calculations. The primary outcome was the postoperative Tegner score, representing a return to sports; secondary outcomes included changes in Tegner and Lysholm scores and failure rates. Two cohort studies and three case series were included, with quality ratings ranging from fair to poor. The mean patient age was 27.8 years, and the mean follow-up was 82.4 months. The pooled postoperative Tegner score was 5.94 (95% CI: 5.41-6.46), indicating a high return to recreational sports. The mean change in Tegner score was 2.48 (p = 0.0604), which was not statistically significant, while Lysholm score improvement was significant at 31.16 points (p = 0.0093). The pooled failure rate across studies was 14% (95% CI: 0-42%). Patients with isolated bucket-handle meniscal tears undergoing surgical repair demonstrate a high rate of return to recreational sports, with significant improvements in Lysholm scores. However, failure rates and study quality variability suggest further high-quality research to make safer conclusions.
桶柄状撕裂是半月板损伤的一种亚型，涉及全层纵向撕裂。这些撕裂具有挑战性且要求较高。本系统评价和荟萃分析旨在评估通过半月板修复手术治疗的孤立性桶柄状半月板撕裂的年轻成年人的运动恢复结果。本评价遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南，由两名独立评审员从PubMed、科学网和Scopus数据库中筛选研究。纳入的研究需涉及16岁以上的患者、孤立性桶柄状撕裂、至少一年的随访，并报告术后Tegner评分。五项研究共168个膝关节符合这些标准并进行了分析。质量评估采用纽卡斯尔-渥太华量表。在R（奥地利维也纳的R统计计算基金会）中进行数据分析以计算合并结果。主要结果是术后Tegner评分，代表恢复运动；次要结果包括Tegner和Lysholm评分的变化以及失败率。纳入了两项队列研究和三项病例系列研究，质量评级从中等到差。患者平均年龄为27.8岁，平均随访时间为82.4个月。术后Tegner评分合并值为5.94（95%CI：5.41 - 6.46），表明恢复娱乐性运动的比例较高。Tegner评分的平均变化为2.48（p = 0.0604），无统计学意义，而Lysholm评分改善显著，为31.16分（p = 0.0093）。各研究的合并失败率为14%（95%CI：0 - 42%）。接受手术修复的孤立性桶柄状半月板撕裂患者恢复娱乐性运动的比例较高，Lysholm评分有显著改善。然而，失败率和研究质量的变异性表明需要进一步开展高质量研究以得出更可靠的结论。
