早期前交叉韧带重建降低远期继发性半月板手术率：一项系统综述
简介
该研究系统评价了前交叉韧带重建（ACLR）时机对半月板损伤的影响，以二次半月板手术率为主要结局指标。将伤后超过6周重建定义为延迟重建。纳入6项研究共933例ACL断裂患者。关键发现：随访超过5年的研究显示，早期ACLR可降低二次半月板手术风险；而随访≤5年的研究未发现早期与延迟重建组间有统计学差异（P=0.02）。亚组分析表明，在长期随访（>5年）中，早期重…
英文摘要
PURPOSE: To evaluate the impact of anterior cruciate ligament reconstruction timing on meniscus injuries, with the rate of secondary meniscus surgery as the primary outcome. METHODS: We define reconstruction performed more than 6 weeks after injury as delayed reconstruction. Literature was obtained from PubMed/MEDLINE, Embase, the Cochrane Library, and the Web of Science. Outcomes compared included secondary meniscus surgery incidence, secondary meniscus injury rates, differences between medial and lateral meniscus injuries, knee function scores, and knee stability. RESULTS: After expert consultation and quality assessment, 6 studies involving 933 patients with anterior cruciate ligament rupture were included. Studies with a follow-up duration greater than 5 years concluded that early anterior cruciate ligament reconstruction (ACLR) reduced the risk of secondary meniscus surgery. In contrast, studies with a follow-up duration of less than or equal to 5 years found no statistically significant difference between the early ACLR group and the delayed ACLR group in terms of secondary meniscus surgery outcomes (P = .02). Subgroup analysis showed that in long-term follow-up (>5 years), the rate of secondary meniscus surgery was significantly lower in the early ACLR group compared with the delayed group, and longer follow-up duration was associated with an increasing trend in the rate of secondary meniscus surgery. CONCLUSIONS: Compared with delayed ACLR, early ACLR reduces long-term (>5 years) rates of secondary meniscus surgery. As time progresses, the difference in the proportion of secondary meniscus surgeries between the 2 groups becomes more pronounced, further highlighting the advantage of early ACLR. LEVEL OF EVIDENCE: Level II, systematic review of Level I and II studies.