全内侧修复是内侧半月板后根部撕裂的有效治疗方法：基于生物力学与临床证据的系统评价和Meta分析
简介
内侧半月板后根部撕裂（MMPRT）的全内修复（AR）是一种有效治疗方法。本系统评价和荟萃分析纳入13项研究，比较了AR与经胫骨拉出修复（TP）及非修复治疗的生物力学和临床结果。关键发现：AR能恢复接触力学，其极限载荷与TP相当，但刚度较低；荟萃分析显示，AR组转为全膝关节置换术（TKA）的风险显著低于非修复组（RR 0.18, 95% CI 0.05-0.5…
英文摘要
BACKGROUND: Medial meniscus posterior root tears (MMPRTs) reproduce the biomechanics of subtotal meniscectomy. Repair is favored, but the role of all-inside repair (AR) remains unclear relative to transtibial pull-out (TP). This study aimed to review the biomechanical and clinical evidence on AR for MMPRTs. METHODS: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in the International Prospective Register of Systematic Reviews (PROSPERO). MEDLINE, Embase, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched. Outcomes included patient-reported outcome measures (PROMs), magnetic resonance imaging (MRI), and biomechanical performance. When available, random-effects meta-analysis was performed. RESULTS: Thirteen studies were included. AR restored contact mechanics and showed load to failure comparable to TP, with lower stiffness. Meta-analysis showed lower conversion to total knee arthroplasty with AR versus non-repair (RR 0.18, 95% CI 0.05-0.58), and no significant PROM differences between AR and TP. CONCLUSIONS: AR showed favorable biomechanical properties and improved outcomes versus non-repair. Compared with TP, no significant clinical differences were observed. AR may represent a reasonable option in selected scenarios.