A meta-analysis comparing meniscal repair with meniscectomy in the treatment of meniscal tears: the more meniscus, the better outcome?

Abstract

The meniscus plays an important role in the knee joint. Meniscal tears are the most common knee injuries, are seen in all age groups and have several causes. Meniscectomy and meniscal repair, including open or arthroscopic procedures, are common operations for orthopaedic surgeons. The purpose of this meta-analysis was to review published articles that compared meniscal repair (open suture and arthroscopic inside-out procedures) with meniscectomy (arthroscopic partial or total meniscectomy) for short- or long-term outcomes and to determine which procedure leads to a better outcome. A search was performed in the MEDLINE, EMBASE and OVID databases. All randomized, quasi-randomized, and observational clinical trials that reported the outcome of meniscal repair and meniscectomy were included in our meta-analysis. The outcomes were International Knee Documentation Committee Score, Lysholm Score, Tegner Score and failure rate. Seven studies were included in this meta-analysis, one of which was a randomized, prospective study. There was a statistically significant difference in favour of meniscal repair for Lysholm Score and Tegner Score. Besides, meniscal repair had a lower failure rate than meniscectomy. Meniscal repairs have better long-term patient-reported outcomes and better activity levels than meniscectomy; besides, the former meniscal repairs have a lower failure rate. Meta-analysis, Level III.