Revisiting Arthroscopic Partial Meniscectomy for Degenerative Tears in Knees with Mild or No Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Objective:The purpose of this systematic review and meta-Analysis was to evaluate the efficacy of arthroscopic partial meniscectomy (APM) for symptomatic degenerative meniscal tear (DMT) in knees with mild or no osteoarthritis.Study Design:A systematic review and meta-Analysis.Methods:MEDLINE, EMBASE, and Cochrane databases were systematically searched. The inclusion criteria were as follows: (1) English language; (2) randomized controlled trial (RCT); (3) comparison between APM and other treatment modalities as a primary objective; and (4) complete DMT in knees with mild or no osteoarthritis. Mild or no arthritis was defined as Kellgren-Lawrence grade 0 to 2 or Ahlbäck 0 to 1 on radiography. Statistical analysis of functional activity and pain after APM and conservative treatment or sham operation was performed using R version 3.3.1.Results:Five articles were included in the final analysis, and they were all RCTs. Four studies compared clinical results of APM with those for physical therapy, and one study compared APM with sham operation. The functional activity was not better in the APM group (296 cases) than in the conservative treatment or sham operation group (284 cases) (I2: 0%, small level of heterogeneity). Pain was not reduced significantly in the APM group compared with that in the conservative treatment or sham operation group (I2: 0∼90%, high level of heterogeneity).Conclusions:This systematic review and meta-Analysis of high-quality literature provides relatively strong evidence that APM did not improve functional activity or reduce pain compared with the results with conservative treatment or sham operation in knees with mild or no osteoarthritis.