Systematic Review and Meta-analysis of Clinical Outcomes Following Meniscus Repair in Patients 40 Years and Older.
| Autor: | Sedgwick, Matthew J., Saunders, Christopher, Getgood, Alan M.J. |
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| Předmět: |
MENISCUS surgery
MEDICAL information storage & retrieval systems RESEARCH funding TREATMENT effectiveness AGE distribution META-analysis DESCRIPTIVE statistics SYSTEMATIC reviews MEDLINE REOPERATION COMPARATIVE studies ONLINE information services HEALTH outcome assessment TREATMENT failure CONFIDENCE intervals DATA analysis software MENISCECTOMY EVALUATION |
| Zdroj: | Orthopaedic Journal of Sports Medicine; Aug2024, Vol. 12 Issue 8, p1-10, 10p |
| 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. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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