■膝关节多韧带损伤(MLKI)严重且难以处理。本研究旨在阐明手术时机对MLKI术后早期和长期结局的影响。
■在整个PubMed中采用了全面的搜索策略,Scopus,WebofScience,还有Cochrane图书馆.研究是使用相关关键词的组合确定的,包括多韧带膝关节损伤,“\”膝盖脱位,\"\"重建,\"\"修复,\"\"手术,\"和\"计时,“和他们的同义词,以及适当的布尔运算符。文章的选择(系统评价和荟萃分析)遵循预定义的纳入和排除标准。此外,利用从主要研究中提取的数据进行荟萃分析.
■MLKI的早期手术比延迟手术具有显着的优势,反映在Lysholm得分明显较高(平均差[MD]3.51;95%置信区间[CI]1.79,5.22),IKDC客观得分(Mantel-Haenszel赔率比[MH-OR]2.95;95%CI1.30,6.69),Tegner活动评分(MD0.38;95%CI0.08,0.69),和梅耶尔的评级(MH-OR5.47;95%CI1.27,23.56)。此外,我们发现继发性软骨损伤的风险显着降低(MH-OR0.33;95%CI0.23,0.48),早期手术组胫骨前平移较低(MD-0.92;95%CI-1.83,-0.01),但在继发性半月板撕裂中没有观察到显著差异,两组之间。然而,早期手术组出现膝关节僵硬的风险也显著增加(MH-OR2.47;95%CI1.22,5.01),需要在麻醉下进行手术的可能性更大(MH-OR3.91;95%CI1.10,13.87).
■MLKI的早期手术改善了功能,和稳定性,并进一步减少关节软骨损伤,但增加了僵硬的风险。
■IV.
■在线版本包含补充材料,可在10.1007/s43465-024-01224-1获得。
UNASSIGNED: Multi-ligament knee injuries (MLKI) are serious and challenging to manage. This study aimed to elucidate the impact of surgical timing on both early and long-term outcomes following an MLKI.
UNASSIGNED: A comprehensive search strategy was employed across PubMed, Scopus, Web of Science, and the Cochrane Library. Studies were identified using a combination of relevant keywords encompassing \"multi-ligament knee injury,\" \"knee dislocation,\" \"reconstruction,\" \"repair,\" \"surgery,\" and \"timing,\" and their synonyms, along with appropriate Boolean operators. Selection of articles (systematic reviews and meta-analyses) adhered to predefined inclusion and exclusion criteria. Furthermore, a meta-analysis was conducted utilizing data extracted from primary studies.
UNASSIGNED: Early surgery for MLKI demonstrated a significant advantage over delayed surgery, reflected by significantly higher Lysholm scores (Mean Difference [MD] 3.51; 95% Confidence Interval [CI] 1.79, 5.22), IKDC objective scores (Mantel-Haenszel Odds Ratio [MH-OR] 2.95; 95% CI 1.30, 6.69), Tegner activity scores (MD 0.38; 95% CI 0.08, 0.69), and Mayer\'s ratings (MH-OR 5.47; 95% CI 1.27, 23.56). In addition, we found a significantly reduced risk of secondary chondral lesions (MH-OR 0.33; 95% CI 0.23, 0.48), lower instrumented anterior tibial translation in the early surgery group (MD -0.92; 95% CI -1.83, -0.01), but no significant difference was observed in the secondary meniscal tears, between the two groups. However, the early surgery group also exhibited a significantly increased risk of knee stiffness (MH-OR 2.47; 95% CI 1.22, 5.01) and a greater likelihood of requiring manipulation under anaesthesia (MH-OR 3.91; 95% CI 1.10, 13.87).
UNASSIGNED: Early surgery for MLKI improves function, and stability, and reduces further articular cartilage damage, but increases the risk of stiffness.
UNASSIGNED: IV.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s43465-024-01224-1.