Clinical and Radiological Outcomes of Meniscal Repair Versus Partial Meniscectomy for Medial Meniscus Root Tears: A Systematic Review and Meta-analysis

Ro KH, Kim JH, Heo JW, Lee DH · Orthopaedic Journal of Sports Medicine

Pooled Lysholm improvement was 33.1 points after repair and 13.1 after partial meniscectomy, summary OR 2.20 (95% CI 1.55 to 3.12); the Tegner activity score did not separate, OR 1.21 (95% CI 0.65 to 2.24). Kellgren-Lawrence grade worsened in 22.2% of repaired knees and 48.3% of resected ones, OR 0.31 (95% CI 0.17 to 0.54). Four of 95 repaired knees were reoperated, at a mean of 44.9 months, and 30 of 92 resected knees, at a mean of 72.3 months — 2.7% and 35.0%, OR 0.05 (95% CI 0.01 to 0.19). The revisions differed in kind as well as in number: a repeat pullout repair after repair, and osteotomy or arthroplasty after resection.

Population

Thirteen studies of primary arthroscopic repair or partial meniscectomy for a medial meniscus root tear, followed a mean of 33.5 months after repair and 47.2 after meniscectomy

Intervention

Meniscal root repair

Comparator

Partial meniscectomy

Limitations

Level IV, and nothing randomised the choice of operation: the odds ratios pool separate cohorts drawn from different papers. The arms were followed for different lengths of time — 44.9 months against 72.3 for the reoperation comparison — which by itself would move both a radiographic endpoint and a reoperation count, though the authors' meta-regression found neither age nor follow-up duration associated with Lysholm improvement or reoperation rate. The radiographic endpoint is progression of Kellgren-Lawrence grade, not a threshold of severe osteoarthritis.