Hyunsuk Jeong, Hyeon Woo Yim, Hun-Jun Park, Youngseung Cho, Hanter Hong, Na Jin Kim, Il-Hoan Oh. IJSC 1999;0:. https://doi.org/10.15283/ijsc17061

While additional procedures correcting accompanying pathological conditions can improve the clinical outcomes of meniscal allograft transplantation (MAT), whether those outcomes are comparable or poorer than those of isolated MAT has yet to be clarified. To evaluate whether there is a difference in clinical outcomes between isolated MAT and MAT combined with other procedures (combined MAT). Meta-analysis and systematic review. For the comparison of clinical outcomes between isolated MAT and combined MAT, the authors searched MEDLINE, Embase, and the Cochrane Library. Studies that separately reported the clinical outcomes of isolated MAT and combined MAT were included. Clinical outcomes were evaluated in terms of patient-reported outcomes (PROs) and complication, reoperation, survivorship, and failure rates. We conducted a meta-analysis of the PROs that were used in more than 3 studies. A total of 24 studies were included in this study. In the meta-analysis, no significant differences in Lysholm scores (95% CI, –5.92 to 1.55; P = .25), Tegner activity scores (95% CI, –0.54 to 0.22; P = .41), International Knee Documentation Committee subjective scores (95% CI, –5.67 to 3.37; P = .62), and visual analog scale scores (95% CI, –0.15 to 0.94; P = .16) were observed between isolated MAT and combined MAT. For PROs that were not included in the meta-analysis, most studies reported no significant difference between the 2 groups. As for the survivorship and failure rates, studies showed varying outcomes. Four studies reported that additional procedures did not affect MAT failure or survivorship. However, 3 studies reported that ligament surgery, realignment osteotomy, and osteochondral autograft transfer were risk factors of failure. One study reported that the medial MAT group in which high tibial osteotomy was performed showed a higher survival rate than the isolated medial MAT group. Overall, there seems to be no significant difference between the postoperative PROs in terms of isolated MAT and combined MAT. However, more data are required to verify the effects of osteotomy and cartilage procedures on the clinical outcomes of MAT. We could not draw conclusions about the differences in complication, reoperation, survivorship, and failure rates between the 2 groups because we did not obtain sufficient data.

Although current guidelines recommend performing endoscopy within 12 hours for acute variceal bleeding (AVB), the optimal timing remains controversial. This study aimed to assess the effect of endoscopy timing on the mortality and rebleeding rates in AVB through a systematic review and meta-analysis of all eligible studies. PubMed, Cochrane Library, and Embase were searched for relevant publications up to January 2019. Overall mortality, rebleeding rate, and other clinical outcomes were determined. For the non-randomized studies, the risk of bias assessment tool was used to assess the methodological quality of the included publications. The Mantel-Haenszel random-effects model of the RevMan software (Cochrane) and the inverse variance method were used to analyse binary end points and continuous outcomes, respectively. This meta-analysis included five studies with 854 and 453 participants who underwent urgent (≤12 hours) and non-urgent endoscopies (>12 hours), respectively. All the included studies were retrospective in nature, because of obvious ethical issues. No significant differences in the severity indexes were found between the urgent and non-urgent groups. Three studies showed 6-week mortality and the others in-hospital mortality as main outcomes. No significant difference in overall mortality rate was found between the groups (odds ratio [OR]: 0.72, 95% confidence interval [CI]: 0.36–1.45, p = 0.36). The rebleeding rate was similar between the two groups (OR: 1.21, 95% CI: 0.76–1.93, p = 0.41). Other outcomes such as successful haemostasis, need for salvage therapy, length of hospital stay, and number of blood transfusions were also similar between the groups. We demonstrated that endoscopy timing does not affect the mortality or rebleeding rate of patients with AVB. Therefore, an appropriate timing of endoscopy would be more important than an urgent endoscopy depending on each patient’s condition.

Yeon-Ji Kim, Woo Chul Chung, Byung Wook Kim, Sung Soo Kim, Jin Il Kim, Na Jin Kim, Jinho Yoo, and Soo Hwan Kim. J Neurogastroenterol Motil 2017;23:504-16. https://doi.org/10.5056/jnm17066

Gyudeok Hwang, Hyunsuk Jeong, Hae Kyung Yang, Hun-Sung Kim, Hanter Hong, Na Jin Kim, Il-Hoan Oh, Hyeon Woo Yim. IJSC 1999;0:. https://doi.org/10.15283/ijsc18076