儿童症状性盘状外侧半月板盘状成形术联合或不联合修复的疗效：一项系统综述
简介
这篇系统综述纳入24项研究共1225例儿童症状性盘状外侧半月板患者，比较了单纯碟形化、碟形化+缝合修复及次全切除术的疗效。结果显示三种术式均显著改善Lysholm评分，单纯碟形化并发症（2.7%）和再手术率（7.3%）最低，而碟形化+修复组再手术率（8.9%）和并发症率（6.8%）最高，但差异可能源于撕裂复杂度和随访时长不同。临床提示应根据术中半月板稳定性和…
英文摘要
PURPOSE: To determine outcomes following operative treatment of symptomatic discoid lateral meniscus (DLM) in pediatric patients. METHODS: In March of 2024, a systematic review of the MEDLINE, EMBASE, and Cochrane Library databases was conducted. Studies were included if they were published between the years 2013 to 2023, evaluated surgical outcomes of DLM in pediatric patients, and had a minimum of 10 patients per study with a 1-year follow-up. The primary outcome measure was clinical outcomes with a secondary outcome of adverse events. Surgical technique cohorts included the following: saucerization only, saucerization + repair, and subtotal meniscectomy. RESULTS: Twenty-four studies met inclusion criteria and were included in the analysis. There was a total of 1225 patients (1401 knees; of the studies that reported sex, there were 524/1075 male patients (48.5%) and 553/1075 (51.5%) female patients) who underwent surgical treatment for DLM. The postoperative follow-up time was 1.2 to 10.1 years, and age range was 8.3 to 13.7 years. Saucerization only, saucerization + repair, and total and subtotal meniscectomy cohorts showed significant improvements in Lysholm scores. Saucerization + repair had the highest reoperation (8.9%) and complication rate (6.8%), while saucerization only had the lowest complication (2.7%) and reoperation rate (7.3%). Osteoarthritis and osteochondritis dissecans were the most common complications reported. CONCLUSIONS: All surgical techniques for symptomatic discoid lateral meniscus in pediatric patients resulted in significant functional improvement and low complication and reoperation rates. Apparent differences between cohorts likely reflect variation in tear complexity and follow-up duration rather than procedural risk. Saucerization with or without repair remains safe and effective when guided by intraoperative assessment of meniscal stability and tear characteristics. LEVEL OF EVIDENCE: Level IV, systematic review of Level III and IV studies.