Background: 

The utilization of meniscal repair techniques continues to evolve in an effort to maximize the rate of healing. Meniscal repair outcomes at a minimum of 5 years postoperatively appear to better represent the true failure rates. Thus, a systematic review and meta-analysis of the current literature was conducted to assess the rate of failure at a minimum of 5 years after meniscal repair.

Methods: 

We performed a systematic review of studies reporting the outcomes of meniscal repair at a minimum of 5 years postoperatively. A standardized search and review strategy was utilized. Failure was defined as recurrent clinical symptoms or a meniscal reintervention to repair or resect the meniscus in any capacity, as defined by the study. When reported, outcomes were assessed relative to anterior cruciate ligament (ACL) status, sex, age, and postoperative rehabilitation protocol. Meta-analyses were performed with a random-effects model.

Results: 

A total of 27 studies of 1,612 patients and 1,630 meniscal repairs were included in this review and meta-analysis. The pooled overall failure rate was 22.6%, while the failure rate of modern repairs (excluding early-generation all-inside devices) was 19.5%. Medial repairs were significantly more likely to fail compared with lateral repairs (23.9% versus 12.6%, p = 0.04). Failure rates were similar for inside-out (14.2%) and modern all-inside repairs (15.8%). Early-generation all-inside devices had a significantly higher failure rate (30.2%) compared with modern all-inside devices (15.8%, p = 0.01). There was no significant difference in meniscal failure rate between repairs with concomitant ACL reconstruction (21.2%) and repairs in ACL-intact knees (23.3%, p = 0.54).

Conclusions: 

Modern meniscal repair had an overall failure rate of 19.5% at a minimum of 5 years postoperatively. Modern all-inside techniques appear to have improved the success rate of meniscal repair compared with use of early-generation all-inside devices. Lateral repairs were significantly more likely to be successful compared with medial repairs, while no difference was seen between patients undergoing meniscal repair with and without concomitant ACL reconstruction.

Level of Evidence: 

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

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超过 5 年的半月板修复结果：系统评价和荟萃分析

背景： 

半月板修复技术的使用不断发展，以最大限度地提高愈合率。术后至少 5 年的半月板修复结果似乎更能代表真实的失败率。因此，对当前文献进行了系统回顾和荟萃分析，以评估半月板修复后至少 5 年的失败率。

方法： 

我们对报告术后至少 5 年半月板修复结果的研究进行了系统评价。使用了标准化的搜索和审查策略。失败被定义为复发的临床症状或半月板重新干预以任何能力修复或切除半月板，如研究所定义。报告时，结果是根据前交叉韧带 (ACL) 状态、性别、年龄和术后康复方案进行评估的。使用随机效应模型进行荟萃分析。

结果： 

本综述和荟萃分析共纳入 27 项研究，涉及 1,612 名患者和 1,630 次半月板修复。汇总的整体故障率为22.6%，而现代维修（不包括早期全内置设备）的故障率为19.5%。与外侧修复相比，内侧修复更容易失败（23.9% 对 12.6%，p = 0.04）。由内而外 (14.2%) 和现代全内维修 (15.8%) 的故障率相似。与现代全内设备（15.8%，p = 0.01）相比，早期全内设备的故障率（30.2%）明显更高。伴随 ACL 重建的修复 (21.2%) 和 ACL 完整膝关节的修复 (23.3%, p = 0.54) 之间的半月板失败率没有显着差异。

结论： 

现代半月板修复术后至少 5 年的总体失败率为 19.5%。与使用早期的全内设备相比，现代全内技术似乎提高了半月板修复的成功率。与内侧修复相比，外侧修复的成功率显着更高，而接受半月板修复的患者在伴有和不伴有 ACL 重建的情况下没有差异。

证据等级： 

治疗级别 IV。有关证据级别的完整描述，请参见作者说明。