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Surgical interventions for meniscal tears: a closer look at the evidence

Abstract

Introduction

The aim of the present study was to compare the outcomes of various surgical treatments for meniscal injuries including (1) total and partial meniscectomy; (2) meniscectomy and meniscal repair; (3) meniscectomy and meniscal transplantation; (4) open and arthroscopic meniscectomy and (5) various different repair techniques.

Materials and methods

The Bone, Joint and Muscle Trauma Group Register, Cochrane Database, MEDLINE, EMBASE and CINAHL were searched for all (quasi) randomized controlled clinical trials comparing various surgical techniques for meniscal injuries. Primary outcomes of interest included patient-reported outcomes scores, return to pre-injury activity level, level of sports participation and persistence of pain using the visual analogue score. Where possible, data were pooled and a meta-analysis was performed.

Results

A total of nine studies were included, involving a combined 904 subjects, 330 patients underwent a meniscal repair, 402 meniscectomy and 160 a collagen meniscal implant. The only surgical treatments that were compared in homogeneous fashion across more than one study were the arrow and inside-out technique, which showed no difference for re-tear or complication rate. Strong evidence-based recommendations regarding the other surgical treatments that were compared could not be made.

Conclusions

This meta-analysis illustrates the lack of level I evidence to guide the surgical management of meniscal tears.

Level of evidence

Level I meta-analysis.

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Corresponding author

Correspondence to Carola F. van Eck.

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Conflict of interest

The authors did not receive any outside funding or grants directly related to the research presented in this manuscript. The authors state that this manuscript is an original work only submitted to this book. The authors hold the rights to all the material presented in this manuscript. All authors contributed to the preparation of this work. Author Job Doornberg has received a research grant from the Marti-Keuning-Eckhardt Foundation for his post-doctoral research. The remaining authors declare that they have no conflict of interest.

Appendix

Appendix

See Tables 2 and 3.

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Mutsaerts, E.L.A.R., van Eck, C.F., van de Graaf, V.A. et al. Surgical interventions for meniscal tears: a closer look at the evidence. Arch Orthop Trauma Surg 136, 361–370 (2016). https://doi.org/10.1007/s00402-015-2351-2

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Keywords

  • Meniscus
  • Meniscectomy
  • Meniscal repair
  • Meniscal transplant
  • Meta-analysis
  • Clinical outcomes