值得信赖的标签,含义不确定的:对于中间半月体后部根撕裂的分类缺乏共识,并且对关节镜的准确性进行了定
Michelangelo Palco1, Gabriele Giuca2, Filippo Familiari3
1Department of Orthopaedic and Trauma Surgery, Casa di Cura Caminiti, Villa San Giovanni, Italy.
概括
对于后部中间半月体根撕裂 (PMMRT) 的现有分类系统缺乏标准化的诊断准确性. 基于MRI的分类显示出很好的一致性,但需要更多的关节镜验证研究才能得到强有力的认可.
科学领域:
- 整形外科和运动医学
- 放射学和医学成像学 医学成像学
- 膝盖外科手术 膝盖外科手术
背景情况:
- 存在多种非标准化的分类系统,用于后部中间半月体根撕裂 (PMMRT).
- 这些PMMRT分类的诊断准确性和观察者可靠性尚未得到充分证实.
- 这一系统性审查解决了对现有PMMRT分类系统的清晰度需求.
研究的目的:
- 列出了可用的分类系统,用于后部中间半月体根撕裂 (PMMRT).
- 系统地审查和总结这些PMMRT分类的诊断准确性和观察者间可靠性指标.
- 确定有关PMMRT分类验证的证据中的潜在缺口.
主要方法:
- 进行了PRISMA-2020的系统审查,搜索了多个数据库 (PubMed,Scopus,Cochrane CENTRAL,Ovid MEDLINE/Embase).
- 搜索包括对人类受试者的英语研究,没有日期或设计限制.
- 偏差风险被评估使用QUADAS-2用于诊断准确性和GRRAS/COSMIN用于可靠性;观察者之间的协议 (κ) 和测量可靠性 (ICC) 被提取.
主要成果:
- 一项研究验证了基于MRI的分类与关节镜相比,报告了辐射PMMRT的高精度 (灵敏度0.90,特异性0.94).
- 两项研究表明,基于MRI的PMMRT分类和诊断具有很高的观察者间一致性 (κ = 0.860.93).
- 对挤出和撕裂间隔的MRI测量可重复性很好或很好 (ICC:0.800.92);没有研究将PMMRT亚型与治疗或结果联系起来.
结论:
- 基于MRI的PMMRT分类显示了观察者之间的高度一致.
- 关节镜验证诊断准确性的证据仍然有限,只有一个合格研究.
- 没有一个单一的PMMRT分类系统可以被最终认可;共识解剖分类和多中心,关节镜验证的研究是标准化所需的.
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