Meta-analysis Of Postoperative Outcomes Of Meniscus Suture Versus Meniscectomy In Patients With Anterior Cruciate Ligament Rupture And Meniscus Injury

Objective:To provide evidence-based medical evidence for clinical diagnosis and treatment,a meta-analysis was conducted to compare the postoperative efficacy of meniscus suture versus meniscectomy in patients with anterior cruciate ligament rupture and meniscus injury.Methods:Two researchers independently searched databases such as Pub Med,EMbase,Cochrane Library,Web of Science,CNKI,Wanfang database,VIP,and CBM through computers,and the search time was from January 2013 to January 2023,Collect relevant literature on the comparison of meniscus suture and meniscectomy for anterior cruciate ligament rupture and meniscus injury,and reconstruction of the anterior cruciate ligament.Gradually screen the collected literature in strict accordance with the inclusion and exclusion criteria,use quality evaluation tools to evaluate the quality of the literature,and extract the indicator data to be analyzed by reading the full text.Use the Review Manager5.4 statistical software to perform meta-analysis on the extracted data,and perform heterogeneity evaluation,sensitivity analysis,and bias judgment on the resulting data.Results:After a complete search and gradual screening,11 articles were eventually included,9 in English and 2 in Chinese.The total sample size for data statistics is 10606 cases,of which 2122 cases were given intervention measures of anterior cruciate ligament reconstruction combined with meniscus suture,and 8484 cases were given intervention measures of anterior cruciate ligament reconstruction combined with meniscus resection.The results of a meta-analysis showed that in patients with anterior cruciate ligament rupture and meniscus injury,there was no statistically significant difference in postoperative Lysholm score,postoperative Tegner score,and postoperative KOOS score between the two groups(P>0.05).However,there was a statistically significant difference between anterior cruciate ligament reconstruction combined with meniscus suture and anterior cruciate ligament reconstruction combined with meniscus resection in terms of postoperative IKDC scores [SMD=0.56,95%CI(0.13,0.99),P=0.01]、postoperative KT-1000 joint relaxation[SMD=-0.11,95%CI(-0.22,-0.00),P=0.04]and the postoperative meniscus healing rate [Peto=3.47,95%CI(1.50,8.04),P=0.004].Conclusion:In the case of anterior cruciate ligament rupture and meniscus injury,while reconstructing the anterior cruciate ligament,meniscus suture can improve the postoperative IKDC joint function score,reduce joint relaxation,and improve the postoperative meniscus healing rate compared to meniscectomy.However,there was no significant difference between meniscus suture and meniscectomy in terms of postoperative pain,swelling,activity,and progression of osteoarthritis.Therefore,in patients with anterior cruciate ligament rupture and meniscus injury,while reconstructing the anterior cruciate ligament,the injured meniscus should be repaired as much as possible to maintain the integrity of the meniscus and promote the functional recovery of the knee joint after surgery.