• Arch Orthop Trauma Surg · Mar 2016

    Review Meta Analysis

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

    • Eduard L A R Mutsaerts, Carola F van Eck, Victor A van de Graaf, Job N Doornberg, and Michel P J van den Bekerom.
    • Department of Orthopaedic Surgery, Joint Research, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
    • Arch Orthop Trauma Surg. 2016 Mar 1; 136 (3): 361-70.

    IntroductionThe 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 MethodsThe 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.ResultsA 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.ConclusionsThis meta-analysis illustrates the lack of level I evidence to guide the surgical management of meniscal tears.Level Of EvidenceLevel I meta-analysis.

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