Meniscal centralization significantly improve clinical outcomes and reduce meniscal extrusion with minimal complications: A systematic review

IF 2.7 Q2 ORTHOPEDICS

Journal of Experimental Orthopaedics Pub Date : 2025-06-15 DOI:10.1002/jeo2.70308

Alessandro Carrozzo, Francesco Bosco, Leandro Ramazzini, Fortunato Giustra, Virginia Masoni, Marcello Capella, Michele Malavolta, Jae-Sung An, Hideyuki Koga

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Abstract

Purpose

Meniscal extrusion alters joint biomechanics and accelerates cartilage degeneration, contributing to the progression of knee osteoarthritis (OA). Meniscal centralization techniques aim to reposition the meniscus, addressing extrusion and restoring load distribution. This systematic review aims to evaluate meniscal centralization's clinical and radiological outcomes, hypothesizing its efficacy in treating symptomatic meniscal extrusion with minimal complications.

Methods

This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered with PROSPERO (CRD42023484353). Literature searches were conducted in PubMed, Science Direct and Scopus. Studies reporting clinical and/or radiological outcomes of meniscal centralization with ≥24 months of follow-up were included. Data on demographics, surgical techniques, patient-reported outcome measures (PROMs), imaging findings and complications were extracted. Methodological quality was assessed using the ROBINS-I tool, and heterogeneity was evaluated via the I² statistic.

Results

Four studies (113 patients, mean follow-up: 24–35 months) met inclusion criteria. Arthroscopic meniscal centralization with suture anchors significantly improved PROMs, including International Knee Documentation Committee (IKDC), Lysholm and Knee Injury and Osteoarthritis Outcome Score (KOOS) scores, demonstrating symptom relief and functional recovery. Lysholm scores improved from 46.0 to 96.5, KOOS pain from 47.4 to 88.9, and IKDC from 51.8 to 75.8 (p < 0.05 for all). Imaging showed reduced meniscal extrusion and improved joint space width. Complications were minimal, though one study reported a 26.9% failure rate due to incomplete healing and OA progression. Rehabilitation protocols allowed return to full activity within 4–6 months.

Conclusions

Meniscal centralization effectively reduces extrusion, improves clinical outcomes, and restores knee function with minimal complications. However, further long-term and comparative studies are needed to validate these findings and refine surgical indications.

Level of Evidence

Level IV.

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半月板集中可显著改善临床结果，减少半月板挤压，并发症最少：一项系统综述

半月板挤压改变关节生物力学，加速软骨退变，促进膝关节骨性关节炎（OA）的进展。半月板集中技术的目的是重新定位半月板，解决挤压和恢复负荷分布。本系统综述旨在评估半月板集中治疗的临床和影像学结果，并假设其在治疗症状性半月板挤压和并发症最少方面的有效性。方法本综述遵循系统评价和荟萃分析指南的首选报告项目，并在PROSPERO注册（CRD42023484353）。在PubMed、Science Direct和Scopus中进行文献检索。研究报告了半月板集中的临床和/或放射学结果，随访≥24个月。提取了人口统计学、手术技术、患者报告的结果测量（PROMs）、影像学结果和并发症的数据。使用ROBINS-I工具评估方法学质量，并通过I2统计量评估异质性。结果4项研究（113例，平均随访24-35个月）符合纳入标准。关节镜下半月板集中缝合锚钉显著改善PROMs，包括国际膝关节文献委员会（IKDC）， Lysholm和膝关节损伤和骨关节炎结局评分（oos）评分，显示症状缓解和功能恢复。Lysholm评分从46.0提高到96.5，kos疼痛从47.4提高到88.9，IKDC从51.8提高到75.8 （p < 0.05）。影像学显示半月板挤压减少，关节间隙宽度提高。并发症很少，尽管一项研究报告了26.9%的失败率，原因是不完全愈合和OA进展。康复方案允许在4-6个月内完全恢复活动。结论半月板集中可有效减少挤压，改善临床效果，恢复膝关节功能，并发症最少。然而，需要进一步的长期和比较研究来验证这些发现并完善手术指征。证据等级四级。

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