半月板修复中血液或纤维蛋白凝块增强的临床结果、结构愈合及失败率：一项系统综述
简介
系统综述纳入7项研究、共237例半月板修复，评估血液或纤维蛋白凝块增强后的临床结局、结构愈合及失败率。完全愈合率为24.1%–91.7%，异质性较大，取决于撕裂特征、评估方式和随访时间；失败或再手术率为0–25%，在退变性水平劈裂或复杂撕裂较多的队列中更高。两项II级研究中，纤维蛋白凝块增强较对照的完全愈合率更高、失败率数值更低，但未持续显示统计学显著性；各…
英文摘要
PURPOSE: To systematically evaluate clinical outcomes, structural healing, and failure rates following meniscus repair augmented with blood or fibrin clot compared with non-augmented repair when available. METHODS: A systematic review was performed. Eligible studies were clinical investigations evaluating meniscus repair augmented with blood or fibrin clot and reporting at least one outcome of interest, including patient-reported outcome measures (PROMs), structural healing, or failure or reoperation rates. Due to substantial heterogeneity, outcomes were synthesized descriptively. RESULTS: Seven studies comprising 237 repaired menisci were included, including two Level II studies and five Level IV studies. Structural healing outcomes were heterogeneous, with complete healing rates ranging from 24.1% to 91.7%, depending on tear characteristics, assessment modality, and follow-up duration. In Level II studies, fibrin clot augmentation was associated with higher rates of complete healing and numerically lower failure rates compared with controls, although statistical significance was not consistently demonstrated. Across all studies, failure or reoperation rates ranged from 0 to 25%, with higher rates observed in cohorts enriched with degenerative horizontal cleavage tears or complex tear patterns. All studies reporting PROMs demonstrated significant postoperative improvement from baseline, regardless of augmentation strategy. CONCLUSION: Blood or fibrin clot augmentation in meniscus repair is associated with favorable but heterogeneous healing outcomes and generally low failure rates. However, current evidence is limited and inconsistent, and further high-quality studies are required to define its clinical role.