Comparison of Long-term Radiographic Outcomes and Rate and Time for Conversion to Total Knee Arthroplasty Between Repair and Meniscectomy for Medial Meniscus Posterior Root Tears: A Systematic Review and Meta-analysis

Krivicich LM, Kunze KN, Parvaresh KC, Jan K, DeVinney A, Vadhera A, LaPrade RF, Chahla J · The American Journal of Sports Medicine

Kellgren-Lawrence progression occurred in 18 of 82 knees (22%) after root repair and 41 of 62 (66%) after meniscectomy, OR 0.17 (95% CI 0.03 to 0.83; P = 0.029). Conversion to total knee arthroplasty occurred in 8 of 82 (9.8%) after repair and 22 of 61 (36%) after meniscectomy, OR 0.15 (95% CI 0.05 to 0.44; P < 0.001). Postoperative IKDC scores did not separate (SMD 0.51; 95% CI -0.02 to 1.05; P = 0.06).

Population

Level III or better studies of medial meniscus posterior root tears with a minimum mean 4-year follow-up; 144 patients for radiographic outcomes, followed a mean of 64.8 months after repair and 62.5 after meniscectomy

Intervention

Arthroscopic root repair

Comparator

Meniscectomy

Limitations

Level IV pooling of level III studies, 144 patients in total, and the structural gap is large while the patient-reported gap is not — a pattern that fits both a real chondroprotective effect and selection of better knees for repair. Full text was not retrievable.