J Korean Med Sci.  2021 Nov;36(45):e292. 10.3346/jkms.2021.36.e292.

Arthroscopic Partial Meniscectomy versus Physical Therapy for Degenerative Meniscal Tear: a Systematic Review

• Choi M
• Lee SJ
• Park CM
• Ryoo S
• Kim S
• Jang JY
• Kim HA

• KMID: 2522549
• DOI: http://doi.org/10.3346/jkms.2021.36.e292

Abstract

Background
Meniscal tears are commonly observed in patients with knee osteoarthritis (OA), however, clinical significance of such lesions detected by magnetic resonance imaging is in many cases unclear. This study aimed to determine the clinical effectiveness of arthroscopic partial meniscectomy (APM) compared with non-operative care in patients with knee OA. Method: We used existing systematic reviews with updates of latest studies. Three randomized controlled studies were selected, where two studies compared the effects of APM plus physical therapy (PT) with PT alone and one compared APM alone and PT alone. While 1 study exclusively included OA patients, 2 studies included 21.1 and 12% of patients with no radiographic OA. Patients with knee locking were unanimously excluded.
Results
Upon comparison of APM plus PT and PT alone, there was no significant difference observed in knee function, physical activity, or adverse events. Knee pain was observed to be significantly lower in the APM plus PT group at 6 months, but there was no difference between the two groups at 12 and 24 months. With respect to the comparison between APM alone and PT alone, PT was non-inferior based on the criteria for knee function during 24 months; however, knee pain was significantly reduced in the APM alone group.
Conclusions
Our study showed that knee pain was significantly improved in the APM group compared to non-operative care group at 6 months and over 24 months. Our result was based on only 3 randomized controlled trials (RCTs) revealing a significant knowledge gap, hence demanding more high-quality RCTs in OA patients.

Keyword

Knee Osteoarthritis; Arthroscopic Partial Meniscectomy; Systematic Review

Figure

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  Fig. 1 Preferred Reporting Items for Systematic Review and Meta-Analyses flow diagram. (A) Step 1: selection of existing SR. (B) Step 2: selection of latest primary articles.RCT = randomized controlled trial, SR = systematic review.

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  Fig. 2 Knee function following APM plus PT versus PT.APM = arthroscopic partial meniscectomy, PT = physical therapy, SD = standard deviation, CI = confidence interval.

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  Fig. 3 Knee pain following APM plus PT versus PT.APM = arthroscopic partial meniscectomy, PT = physical therapy, SD = standard deviation, CI = confidence interval.

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  Fig. 4 Physical activity following APM plus PT versus PT.APM = arthroscopic partial meniscectomy, PT = physical therapy, SD = standard deviation, CI = confidence interval.

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