经胫骨隧道拉出修复内侧半月板后根部撕裂术后康复：系统评价与Meta分析
简介
本研究系统回顾了经胫骨隧道拉出修复术治疗内侧半月板后根部撕裂（MMPRTs）后的康复方案，并评估康复参数与患者报告结局指标（PROMs）变化的关系。共纳入31项研究，其中17项进入荟萃分析。关键发现：术后IKDC评分平均提高28.5分（95%CI 23.8-33.2），KOOS生活质量、运动/娱乐及VAS疼痛评分均有显著改善。美国和亚洲队列在支具使用时长上存…
英文摘要
PURPOSE: To characterise rehabilitation protocols after transtibial pullout repair for medial meniscus posterior root tears (MMPRTs) and evaluate whether study-level rehabilitation parameters were associated with longitudinal changes in patient-reported outcome measures (PROMs). METHODS: A systematic database search was conducted from inception to 2 June 2025, and updated on 2 February 2026. Study-level data were extracted, including rehabilitation protocols and PROMs. For each study, mean change scores were calculated as the difference between post-operative follow-up and preoperative baseline PROM values. When not reported, the standard deviation of the change score was imputed from baseline and follow-up standard deviations assuming a pre-post correlation (r) of 0.5; sensitivity analyses used r = 0.3 and r = 0.7. Random-effects meta-analysis with Hartung-Knapp adjustment determined overall PROM improvement, and rehabilitation variable effects were tested through study-level meta-regression. RESULTS: Overall, 31 studies were included, with 17 in the meta-analysis. Pooled mean change scores demonstrated substantial post-operative improvements in International Knee Documentation Committee (IKDC) (28.5 [95% confidence interval [CI] 23.8-33.2]), Knee injury and Osteoarthritis Outcome Score Quality of Life (KOOS QoL) (33.9 [95% CI 22.2-45.6]), KOOS Sport/Rec (33.1 [95% CI 26.0-40.3]), and visual analog scale (VAS) pain (-34.6 [95% CI -40.1 to -29.1]) scores. Pooled estimates were stable using alternative assumptions for change-score variance. Comparing USA and Asian cohorts, bracing duration differed significantly, with USA cohorts more commonly using post-operative bracing for ≥6 weeks; other evaluated rehabilitation variables did not differ significantly. No detectable associations were identified in exploratory study-level meta-regression analyses, although between-study heterogeneity was substantial. CONCLUSION: Rehabilitation protocols after transtibial pullout repair for MMPRTs are heterogeneous. Patients demonstrated substantial longitudinal PROM improvements; however, no detectable associations were identified between evaluated rehabilitation protocol variables and IKDC improvement. These findings are limited by observational study design, high heterogeneity, ecological bias and insufficient power. LEVEL OF EVIDENCE: Level IV.