膝内侧半月板根部撕裂修复与切除的荟萃分析

Meniscus repair versus meniscectomy for medial meniscus posterior root tears of the knee: a meta- analysis

摘要:

[目的] 汇集已发表文献中的数据，比较修复术与切除术治疗膝内侧半月板根部撕裂 (medial meniscus posterior root tears, MMPRT) 的临床效果。[方法] 检索建库至 2020 年 10 月，PubMed、Cochrane 图书馆、Web of Science 及中国知网 (CNKI)、万方医学、维普数据库中关于 MMPRT 修复术与部分切除术比较的文献，由两名研究员标准筛选、数据提取、质量评估。采用 Review Manager 5.4 软件进行荟萃分析。[结果] 纳入 6 项研究，共 263 例患者，其中修复术 149 例，部分切除术 114 例。荟萃分析表明，在 Lysholm 评分 (MD=9.72, 95%CI 3.27-16.16, P=0.003)、IKDC 评分 (MD=11.91, 95%CI 1.21-22.61, P= 0.03)、Kellgren-Lawrence 等级 (OR=0.09, 95%CI 0.04-0.21, P＜0.001) 和行全膝关节置换术 (OR=0.10, 95%CI 0.04-0.24, P＜ 0.001)方面，修复术均优于切除术。[结论]对于 MMPRT 的治疗，修复术在临床评分及长期预后方面均明显优于切除术。

Abstract:

[Objective] To compare the clinical outcomes of meniscus repair versus meniscectomy for medial meniscus posterior root tears (MMPRT) by summarizing data from the published literatures. [Methods] The articles regarding comparison of meniscus repair with meniscectomy for MMPRT were retrieved from data bases, such as PubMed, Cochrane Library, Web of Science, CNKI, Wanfang Medical, and Weipu databases from the establishment to October 2020. After screening, data extraction, and quality evaluation were finished by two researchers, a meta-analysis was conducted by using Review Manager 5.4 software. [Results] A total of 6 papers were enrolled into this study, involving 263 patients, including 149 cases of meniscus repair and 114 cases of partial meniscectomy. As results of meta-analysis, meniscus repair proved significantly superior to the meniscectomy in terms of Lysholm score (MD=9.72, 95%CI 3.27-16.16, P=0.003) , IK- DC score (MD=11.91, 95%CI 1.21-22.61, P=0.03) , Kellgren -Lawrence grade (OR=0.09, 95%CI 0.04-0.21, P＜0.001) , and total knee ar- throplasty (OR=0.10, 95%CI 0.04-0.24, P＜0.001) . [Conclusion] For the treatment of MMPRT, meniscus repair is significantly better than the meniscectomy regarding to clinical scores and long-term prognosis in this study.