Systematic Review and Meta-analysis of Clinical Outcomes Following Meniscus Repair in Patients 40 Years and Older.

Autor:	Sedgwick MJ; Smith+Nephew, Hull, UK., Saunders C; Smith+Nephew, Hull, UK., Getgood AMJ; Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada.; Lawson Health Research Institute, London, Ontario, Canada.; London Health Sciences Centre, London, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	Orthopaedic journal of sports medicine [Orthop J Sports Med] 2024 Aug 08; Vol. 12 (8), pp. 23259671241258974. Date of Electronic Publication: 2024 Aug 08 (Print Publication: 2024).
DOI:	10.1177/23259671241258974
Abstrakt:	Background: Meniscal repair has been associated with long-term benefit in patients compared with meniscectomy. As a generalization, meniscal repair in older patients is less likely to be successful, leading to reduced adoption of meniscal repair compared with younger patients. Purpose: To establish the clinical performance of meniscal repair in "older" patients (age, ≥40 years) and compare it with performance in "younger" patients (age, <40 years). Study Design: Systematic review; Level of evidence, 4. Methods: A systematic literature review was performed in September 2021 using Embase and PubMed to identify published English-language studies that reported on a meniscal repair in >5 patients aged ≥40 years. Outcomes of interest were success/failure rate (as defined by the study), revision meniscal procedure rate, and patient-reported outcomes. Meta-analyses were used to synthesize outcomes across all studies in older patients. Meta-analyses were also used to compare outcomes between older and younger patients across studies, providing data on both age groups. Results: Fourteen studies were identified. Meniscal repair in older patients was determined to have a failure rate of 12% (95% CI, 7.3% to 19.4%) and a revision meniscal procedure rate of 9.8% (95% CI, 6.2% to 15.0%). The postoperative Lysholm score was 86.7 (95% CI, 81.7 to 91.7). No statistically significant differences were observed between older and younger patients in failure rate (relative risk [RR], 0.73 [95% CI, 0.44 to 1.21]; P = .2205), revision meniscal procedure rate (RR, 0.69 [95% CI, 0.41 to 1.16]; P = .1613), or Lysholm scores (mean difference, 2.3 [95% CI, -4.7 to 9.2]; P = .5278, 4 studies). Conclusion: Meniscal repair in selected patients aged ≥40 years resulted in good success rates and patient-reported outcome measures, which appear similar to those reported for patients aged <40 years. Therefore, meniscal repairs can be performed in at least a specific portion of "older" patients, and age per se should not be the sole determining factor in whether to perform a meniscal repair. Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: A.M.J.G. is a paid consultant of Smith+Nephew and received funds for the completion of this work; received reimbursement from Smith+Nephew for attending a symposium; received a fee from Smith+ Nephew for speaking or for organizing an educational program; received a payment to write a paper from Smith+Nephew; received funds for research from Smith+Nephew; received funds for Clinical Fellow from Smith+Nephew; received royalties or fees for consulting from Smith+Nephew; receives research support from Ossur; owns stock of LinkX Robotics, Ostesys Robotics, and Spring Loaded Technologies, as well as Precision OS stock options. M.J.S. is a paid employee of Smith+Nephew. C.S. is a paid employee of Smith+Nephew. No sponsorship was received for this work; however, the work was performed as normal work of M.J.S. and C.S. as paid employees of Smith+Nephew. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. (© The Author(s) 2024.)
Databáze:	MEDLINE
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