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盘状外侧半月板的手术治疗:结局的系统评价

Surgical Management of the Discoid Lateral Meniscus: a Systematic Review of Outcomes.

作者信息

Vivekanantha Prushoth, Thomas Rhea, Kaplan Gabriel, Ho Matthew, de Sa Darren, Kay Jeffrey

机构信息

Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.

Michael DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.

出版信息

Curr Rev Musculoskelet Med. 2025 May 19. doi: 10.1007/s12178-025-09980-9.

Abstract

PURPOSE OF REVIEW

The discoid lateral meniscus is an abnormal variant that can lead to pain and mechanical symptoms. This review aims to summarize the clinical outcomes after surgical management of the discoid lateral meniscus. Procedures included saucerization/meniscectomies, repair, or meniscus allograft transplantation.

RECENT FINDINGS

A total of 52 articles were included, consisting of 4,503 patients (4,784 knees). Weighted preoperative and postoperative Lysholm scores were 57.8 and 88.6, respectively, with 100% of studies (27/27) finding a significant improvement in scores postoperatively. Weighted preoperative and postoperative IKDC scores were 59.6 and 87.3, respectively, with 88.9% of studies (8/9) finding a statistically significant improvement in scores. Weighted preoperative and postoperative Tegner scores were 4.8 and 7.3, respectively, with 100% of studies (5/5) finding a statistically significant improvement in scores postoperatively. Weighted preoperative and postoperative VAS scores were 5.3 and 3.2, respectively, with 100% of studies (5/5) finding a statistically improvement in scores postoperatively. Amongst patients with reported values, 209 (6.6%; range 0-23.7%) suffered retears, while there were 290 reoperations (6.0%; range: 0-36.7%). Complications included persistent pain, mechanical symptoms, or swelling (n = 115; 2-4%). Studies to date have reported good outcomes overall following surgical management of the discoid lateral meniscus, with significant improvements in PROMs. However, retear and reoperation rates within the literature have been reported to be as high as 23.7% and 36.7%, respectively.

摘要

综述目的

盘状外侧半月板是一种异常变异,可导致疼痛和机械症状。本综述旨在总结盘状外侧半月板手术治疗后的临床结果。手术方法包括半月板修整/切除术、修复术或半月板同种异体移植术。

最新发现

共纳入52篇文章,涉及4503例患者(4784膝)。术前和术后Lysholm评分的加权平均值分别为57.8和88.6,所有研究(27/27)均发现术后评分有显著改善。术前和术后IKDC评分的加权平均值分别为59.6和87.3,88.9%的研究(8/9)发现评分有统计学显著改善。术前和术后Tegner评分的加权平均值分别为4.8和7.3,所有研究(5/5)均发现术后评分有统计学显著改善。术前和术后VAS评分的加权平均值分别为5.3和3.2,所有研究(5/5)均发现术后评分有统计学改善。在报告了相关数值的患者中,209例(6.6%;范围0 - 23.7%)出现再次撕裂,290例进行了再次手术(6.0%;范围:0 - 36.7%)。并发症包括持续疼痛、机械症状或肿胀(n = 115;2 - 4%)。迄今为止的研究报告显示,盘状外侧半月板手术治疗总体效果良好,患者报告结局量表(PROMs)有显著改善。然而,文献报道的再次撕裂率和再次手术率分别高达23.7%和36.7%。

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