Factors predicting functional and radiographic outcomes after arthroscopic partial meniscectomy: A review of the literature

被引:65
作者
Meredith, DS
Losina, E
Mahorned, NN
Wright, J
Katz, JN
机构
[1] Brigham & Womens Hosp, Div Rheumatol Immunol & Allergy, Boston, MA 02115 USA
[2] Brigham & Womens Hosp, Dept Orthopaed Surg, Boston, MA 02115 USA
[3] Harvard Univ, Sch Med, Cambridge, MA 02138 USA
[4] Brigham & Womens Hosp, Sect Clin Sci, Boston, MA 02115 USA
[5] Brigham & Womens Hosp, Robert B Brigham Arthrit & Musculoskeletal Dis Cl, Boston, MA 02115 USA
[6] Boston Univ, Sch Med, Dept Med, Boston, MA 02118 USA
[7] Boston Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02215 USA
[8] Univ Toronto, Dept Orthopaed Surg, Toronto Western Hosp, Univ Hlth Network, Toronto, ON, Canada
关键词
knee; arthroscopy; partial rneniscectomy; predictors; functional outcomes; radiographic outcomes;
D O I
10.1016/j.arthro.2004.10.003
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
We reviewed articles examining the associations between factors identifiable before or during arthroscopic partial meniscectomy (APM) and functional and radiographic outcomes. We assessed the magnitude of effect and statistical significance of associations between predictor variables and outcomes within each Study. We then qualitatively synthesized these observations across multiple studies. Twenty-five studies met our criteria for inclusion. Eight of the studies had a prospective design. There were no randomized, controlled trials. The Studies had important methodological limitations. Greater size of meniscal resection and female gender showed the strongest and most consistent associations with greater radiographic evidence of osteoarthritis across multiple studies. Greater articular cartilage degeneration assessed at Surgery, greater size of meniscal resection. greater laxity of the anterior cruciate ligament, and prior surgery on the index knee were the strongest predictors of worse functional outcomes. Patients with worse preoperative health status (SF-36 score <60), Workers' Compensation, and pending litigation had worse functional outcomes, but these factors were examined in only 1 study. There was consistently no significant difference in radiographic or functional outcome between medial or lateral meniscal injury. Clinicians should incorporate these predictors of outcome into their conversations with patients regarding the advantages and drawbacks of APM.
引用
收藏
页码:211 / 223
页数:13
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