Comparison in Efficacy of Arthroscopic Surgery and Nonsurgical Therapies in Treatment of Meniscus-related Injuries:A Systematic Review and Meta-analysis
10.3870/j.issn.1672-0741.23.09.011
- VernacularTitle:关节镜手术与非手术疗法治疗半月板相关损伤的疗效对比:系统评价和Meta分析
- Author:
Zhixiang LIU
1
;
Hongpeng LI
;
Qipei JI
Author Information
1. 成都中医药大学 养生康复学院,成都 610075
- Keywords:
meniscus injury;
surgical therapy;
non-surgical therapy;
arthroscopic surgery;
Meta-analysis
- From:
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
2024;53(3):380-388
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the short-term and long-term efficacy of arthroscopic surgery,different non-surgical ther-apy and sham operation intervention in the treatment of meniscus related injuries,and to compare their advantages and disadvan-tages,so as to provide guidance for clinical practice.Methods Randomized controlled trials on arthroscopic surgery,meniscecto-my and other surgical and non-surgical treatments for knee meniscus injury were searched in PubMed,Embase,Cochrane Librar-y and Web of Science,and the search time was from its inception to July 2023.Two researchers independently screened the liter-ature according to the established literature ranking criteria,and the Cochrane Risk of Bias Assessment Tool was used to evalu-ate the risk of bias of the included literature,while the PEDro Scale Evaluation Tool was used to evaluate the quality of the liter-ature of the randomized controlled trials,and the collected data were quantitatively analyzed using RevMan 5.3 software.Results From the qualitative analysis,it was clear that surgical therapies might be more appropriately applied to patients without osteo-arthritis and without mechanical symptoms,and that meniscal suture repair surgery had a more favorable long-term outcome compared with traditional partial meniscectomy.Quantitative analysis showed that there was no statistical significance between arthroscopic surgery and other non-surgical therapies in several short and long term efficacy(all P＞0.05).For example,MD=0.15,95％CI:-4.05～4.35,I2=0％in the short-term comparison of Lysholm knee score;MD=-1.30,95％CI:-3.16～0.57,I2=0％;Short-term VAS score MD=-0.18,95％CI:-0.59～0.23,I2=45％;MD=-0.01,95％CI:-0.20～0.19,I2=36％.In addition,in the subgroup analysis of degenerative meniscus injury alone,the difference in clinical efficacy between the two therapies was also not statistically significant(all P＞0.05).Conclusion There is no practical difference between surgi-cal therapy and non-surgical therapy in the short-term and long-term outcomes.For single type injury,such as degenerative me-niscus injury,there is no practical difference between the two therapies.
