Background:

Arthroscopic-assisted meniscal allograft transplantation (MAT) has become a viable and effective treatment option for young active patients with postmeniscectomy pain. The minimal clinically important difference (MCID) of patient-reported outcome measures (PROMs) is imperative to evaluate the clinical significance of surgical interventions and inform clinical practice guidelines in orthopaedic surgery.

Purpose:

To perform a systematic review of clinical outcome studies of patients undergoing MAT and compare postoperative improvement with established MCID thresholds.

Study Design:

Systematic review and meta-analysis; Level of evidence, 4.

Methods:

A systematic review was performed using the PubMed, Web of Science, and Cochrane Library databases. A meta-analysis was performed using data obtained from studies reporting patient-reported outcomes. Subgroup analysis was performed on patients undergoing isolated lateral MAT using fresh-frozen grafts. Weighted mean postoperative improvements in the International Knee Documentation Committee (IKDC), Lysholm, and visual analog scale for pain (VAS pain) were calculated and compared with MCID values to determine if they met the MCID threshold.

Results:

A total of 35 studies were identified, including 1658 unique patients. Weighted mean postoperative score improvements exceeded MCID thresholds for the VAS pain, IKDC, and Lysholm. Subgroup analysis of patients undergoing isolated lateral fresh-frozen MAT demonstrated postoperative improvements exceeding the MCID for the Lysholm and VAS pain.

Conclusion:

Evaluating postoperative PROMs with respect to the MCID is crucial to evaluate the effect of MAT on functional improvement. The results of the present meta-analysis suggest that postoperative improvements after MAT are clinically meaningful as reflected by PROMs exceeding the MCID threshold for the IKDC, Lysholm, and VAS pain.

中文翻译：

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半月板同种异体移植的临床结果与最小的临床重要差异

背景：

关节镜辅助半月板同种异体移植（MAT）已成为患有半月板切除术后疼痛的年轻活跃患者的可行且有效的治疗选择。患者报告结果测量 (PROM) 的最小临床重要差异 (MCID) 对于评估手术干预的临床意义并为骨科手术的临床实践指南提供信息至关重要。

目的：

对接受 MAT 的患者的临床结果研究进行系统评价，并将术后改善与既定的 MCID 阈值进行比较。

学习规划：

系统评价和荟萃分析；证据水平，4。

方法：

使用 PubMed、Web of Science 和 Cochrane 图书馆数据库进行了系统评价。使用从报告患者报告结果的研究中获得的数据进行荟萃分析。使用新鲜冷冻移植物对接受孤立侧垫的患者进行亚组分析。计算国际膝关节文献委员会 (IKDC)、Lysholm 和疼痛视觉模拟量表 (VAS 疼痛) 的加权平均术后改善情况，并与 MCID 值进行比较，以确定它们是否符合 MCID 阈值。

结果：

共确定了 35 项研究，包括 1658 名独特的患者。加权平均术后评分改善超过了 VAS 疼痛、IKDC 和 Lysholm 的 MCID 阈值。对接受单独外侧新鲜冷冻 MAT 的患者的亚组分析表明，Lysholm 和 VAS 疼痛的术后改善超过了 MCID。

结论：

根据 MCID 评估术后 PROM 对于评估 MAT 对功能改善的影响至关重要。本荟萃分析的结果表明，MAT 后的术后改善具有临床意义，正如 PROM 超过 IKDC、Lysholm 和 VAS 疼痛的 MCID 阈值所反映的那样。