PDF(Pubmed)
Abstract：
UNASSIGNED: Meniscal injuries are common in knee surgery and often require preservation techniques to prevent secondary osteoarthritis. Despite advancements in repair techniques, some patients undergo partial meniscectomy, which can lead to postmeniscectomy syndrome. To address these challenges, meniscal substitution techniques like scaffolds have been developed. However, a comprehensive synthesis of the existing evidence through an umbrella review is lacking.
UNASSIGNED: A comprehensive search was conducted in the MEDLINE, Embase and Scopus databases to identify relevant systematic reviews and meta-analyses. Studies were screened based on predefined inclusion and exclusion criteria. The quality of included studies was assessed using the AMSTAR-2 tool.
UNASSIGNED: A total of 17 studies met the inclusion criteria and were included in the review. Most studies focused on the use of collagen-based scaffolds, with fewer studies evaluating synthetic scaffolds. The majority of studies (52.9%) were rated as having \'Critically Low\' overall confidence, with only one study (5.9%) rated as \'High\' confidence and most studies exhibiting methodological limitations, such as small sample sizes and lack of long-term follow-up. Despite these limitations, the majority of studies reported positive short-term outcomes, including pain relief and functional improvement, following scaffold implantation. However, some studies noted a relatively high failure rate. Radiographically, outcomes also varied, with some studies reporting morphological deterioration of the implant seen on MRI, while others noted possible chondroprotective effects.
UNASSIGNED: Meniscal scaffold-based approaches show promise in the management of meniscal deficiency; however, the current evidence is limited by methodological shortcomings. One notable gap in the literature is the lack of clear guidelines for patient selection and surgical technique. Future research should focus on conducting well-designed randomized controlled trials with long-term follow-up to further elucidate the benefits and indications of these techniques in clinical practice. Additionally, efforts should be made to develop consensus guidelines to standardize the use of meniscal scaffolds and improve patient outcomes. Despite limited availability, synthesizing the literature on meniscal scaffold-based approaches is crucial for understanding research, guiding clinical decisions and informing future directions.
UNASSIGNED: Level IV.
UNASSIGNED: A comprehensive search was conducted in the MEDLINE, Embase and Scopus databases to identify relevant systematic reviews and meta-analyses. Studies were screened based on predefined inclusion and exclusion criteria. The quality of included studies was assessed using the AMSTAR-2 tool.
UNASSIGNED: A total of 17 studies met the inclusion criteria and were included in the review. Most studies focused on the use of collagen-based scaffolds, with fewer studies evaluating synthetic scaffolds. The majority of studies (52.9%) were rated as having \'Critically Low\' overall confidence, with only one study (5.9%) rated as \'High\' confidence and most studies exhibiting methodological limitations, such as small sample sizes and lack of long-term follow-up. Despite these limitations, the majority of studies reported positive short-term outcomes, including pain relief and functional improvement, following scaffold implantation. However, some studies noted a relatively high failure rate. Radiographically, outcomes also varied, with some studies reporting morphological deterioration of the implant seen on MRI, while others noted possible chondroprotective effects.
UNASSIGNED: Meniscal scaffold-based approaches show promise in the management of meniscal deficiency; however, the current evidence is limited by methodological shortcomings. One notable gap in the literature is the lack of clear guidelines for patient selection and surgical technique. Future research should focus on conducting well-designed randomized controlled trials with long-term follow-up to further elucidate the benefits and indications of these techniques in clinical practice. Additionally, efforts should be made to develop consensus guidelines to standardize the use of meniscal scaffolds and improve patient outcomes. Despite limited availability, synthesizing the literature on meniscal scaffold-based approaches is crucial for understanding research, guiding clinical decisions and informing future directions.
UNASSIGNED: Level IV.
摘要：
■半月板损伤在膝关节手术中很常见，通常需要保存技术来预防继发性骨关节炎。尽管修复技术有了进步，一些患者接受半月板部分切除术，会导致半月板切除术后综合征.为了应对这些挑战，半月板替代技术如支架已经开发。然而,缺乏通过总括审查对现有证据的全面综合。
■在MEDLINE中进行了全面搜索，Embase和Scopus数据库，以确定相关的系统评价和荟萃分析。根据预定义的纳入和排除标准筛选研究。使用AMSTAR-2工具评估纳入研究的质量。
■共有17项研究符合纳入标准，被纳入综述。大多数研究集中在使用胶原基支架，与较少的研究评估合成支架。大多数研究(52.9%)被评为“严重低”的总体置信度，只有一项研究(5.9%)被评为“高置信度”，大多数研究表现出方法学上的局限性，如样本量小，缺乏长期随访。尽管有这些限制,大多数研究报告了积极的短期结果，包括疼痛缓解和功能改善，支架植入后。然而,一些研究指出，故障率相对较高。射线照相,结果也各不相同，一些研究报告在MRI上看到植入物的形态恶化，而其他人则指出了可能的软骨保护作用。
■基于半月板支架的方法在治疗半月板缺乏症方面显示出希望；然而，目前的证据受到方法论缺陷的限制。文献中一个值得注意的差距是缺乏明确的患者选择和手术技术指南。未来的研究应集中在进行精心设计的随机对照试验和长期随访，以进一步阐明这些技术在临床实践中的益处和适应症。此外,应努力制定共识指南,以规范半月板支架的使用并改善患者预后.尽管可用性有限，综合关于半月板支架方法的文献对于理解研究至关重要，指导临床决策并告知未来方向。
■四级。
■在MEDLINE中进行了全面搜索，Embase和Scopus数据库，以确定相关的系统评价和荟萃分析。根据预定义的纳入和排除标准筛选研究。使用AMSTAR-2工具评估纳入研究的质量。
■共有17项研究符合纳入标准，被纳入综述。大多数研究集中在使用胶原基支架，与较少的研究评估合成支架。大多数研究(52.9%)被评为“严重低”的总体置信度，只有一项研究(5.9%)被评为“高置信度”，大多数研究表现出方法学上的局限性，如样本量小，缺乏长期随访。尽管有这些限制,大多数研究报告了积极的短期结果，包括疼痛缓解和功能改善，支架植入后。然而,一些研究指出，故障率相对较高。射线照相,结果也各不相同，一些研究报告在MRI上看到植入物的形态恶化，而其他人则指出了可能的软骨保护作用。
■基于半月板支架的方法在治疗半月板缺乏症方面显示出希望；然而，目前的证据受到方法论缺陷的限制。文献中一个值得注意的差距是缺乏明确的患者选择和手术技术指南。未来的研究应集中在进行精心设计的随机对照试验和长期随访，以进一步阐明这些技术在临床实践中的益处和适应症。此外,应努力制定共识指南,以规范半月板支架的使用并改善患者预后.尽管可用性有限，综合关于半月板支架方法的文献对于理解研究至关重要，指导临床决策并告知未来方向。
■四级。
