前交叉韧带完整膝关节中促进半月板撕裂愈合的手术增强技术：一项系统综述
简介
本研究系统综述了在ACL完好膝中，采用手术增强技术（SAT，包括骨髓刺激、锉刮和钻孔）辅助单纯半月板修复的效果。共纳入12项研究、387例患者。结果显示，SAT操作简单、安全、省时，且未报告严重不良事件。在疗效方面，一项研究发现骨髓刺激技术优于标准修复；三项研究显示增强修复可获得更好的功能结局，但另有两项研究认为无差异。翻修率在0%至48%之间，不同研究间手…
英文摘要
IMPORTANCE: Studies remain divided on the use of surgical augmentation techniques (SAT) to optimize outcomes after isolated meniscal repair. Aim or ObjectiveTo analyze the revision rates, clinical outcomes and the advantages and disadvantages of SAT for isolated meniscal repairs. The hypothesis was that SAT would improve the results of meniscal repair in anterior cruciate ligament (ACL) intact knees. EVIDENCE REVIEW: A systematic review using the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines was conducted. PubMed, Cochrane, and EMBASE databases were queried in June 2025 for publications on isolated meniscal repair with SAT; SAT included marrow stimulation, rasping and trephination. Study design, patient demographics, characteristics of the meniscal tear, surgical technique, type of SAT, postoperative rehabilitation protocols, outcome measures, follow-up duration, and any advantages or disadvantages of the SAT were recorded, reviewed, and analyzed by two independent reviewers. Studies were assessed for quality and risk of bias by two appraisal tools. FINDINGS: Of 2364 articles screened, 12 met the inclusion criteria, for a total of 387 patients who underwent SAT to enhance meniscal tear healing in ACL-intact knees. Among these, 50% (6/12) used marrow stimulation, 42% (5/12) rasping, and 17% (2/12) trephination. In one study, rasping was combined with marrow stimulation. There was one randomized controlled trial and six studies with a control group. Revision rates were reported in seven studies and ranged from 0% to 48%. One study found that marrow stimulation was beneficial over standard repair techniques. Three studies reported better functional outcomes with augmented repair compared to standard repair, while two found no difference. No major adverse events were reported. There was marked heterogeneity in surgical methods for the three SAT approaches and in post-operative rehabilitation protocols. CONCLUSION AND RELEVANCE: Isolated meniscal repair with SAT appears to be simple, safe, time-efficient, without any adverse impact on outcomes and with no identified contraindications, supporting its use in clinical practice. Further randomized controlled trials are required to confirm the efficacy of the various techniques and to determine whether one technique is superior to another. LEVEL OF EVIDENCE: III.