Arthroscopic partial meniscectomy combined with medical exercise therapy versus isolated medical exercise therapy for degenerative meniscal tear: A meta-analysis of randomized controlled trials
- PMID: 32522685
- DOI: 10.1016/j.ijsu.2020.05.035
Arthroscopic partial meniscectomy combined with medical exercise therapy versus isolated medical exercise therapy for degenerative meniscal tear: A meta-analysis of randomized controlled trials
Abstract
Background: Degenerative meniscal tear is a chronic disorder which presents with knee pain, swelling and loss of motion. It is currently unknown whether arthroscopic partial meniscectomy combined with medical exercise therapy is superior to isolated medical exercise therapy for degenerative meniscal tear.
Objective: To determine if medical exercise therapy alone is as effective as arthroscopic partial meniscectomy combined with medical exercise therapy in treating degenerative meniscal tear.
Method: Electronic searches were performed using MEDLINE, EMBASE, and the Cochrane Library Databases for all randomized studies. Two reviewers independently completed the literature screening, data extraction, and risk evaluation of bias. The outcome measures were visual analogue scale (VAS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), range of motion, the Lysholm Knee Scoring Scale (LKSS), Knee injury and Osteoarthritis Outcome Score (KOOS) and postoperative complications. STATA 13.0 software was applied for meta-analysis.
Result: Six randomized controlled trials (RCTs) were conducted, with 900 patients included. The present study revealed that there were significant differences between the two groups regarding the VAS at two months, as well as, WOMAC and range of motion. No significant differences were found in terms of LKSS, KOOS or postoperative complications.
Limitations: (1) Only 6 RCTs were included in our meta-analysis and the sample sizes were small; (2) The follow-up period was too short in some included studies. Long-term follow-up studies should be conducted in the future; (3) Heterogeneity among the included studies was unavoidable due to different grade of degenerative meniscal tear and program of exercise. Heterogeneity was also caused by a variety of other factors. (4) Publication bias that came from the process of literature searching was unavoidable and was hard to overcome. (5) There are many other words which could yielded more studies (Ex. physiotherapy, physical therapy modalities, exercise therapy, rehabilitation, knee, placebo, groups, tibial meniscus, meniscus, arthroscopy, meniscectomy, partial meniscectomy, randomized controlled trial, controlled clinical trial, randomized, systematic review, and meta-analysis). Implications of key findings: This meta-analysis suggests that doctors can choose arthroscopic partial meniscectomy combined with medical exercise therapy for the treatment of degenerative meniscal tear.
Conclusion: Arthroscopic partial meniscectomy combined with medical exercise therapy is effective in reducing pain and improving range of motion in the early postoperative period. Therefore, arthroscopic partial meniscectomy combined with medical exercise therapy may be recommended for the treatment of degenerative meniscal tear. Further research is necessary to determine the type, frequency, and duration of the best exercise program. Systematic review registration number: Reviewregistry884.
Keywords: Arthroscopic partial meniscectomy; Medical exercise therapy; Meniscal tear; Meta-analysis.
Copyright © 2020 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.
Conflict of interest statement
Declaration of competing interest There is no conflict of interest.
Comment in
-
An uninvited commentary on "Arthroscopic partial meniscectomy combined with medical exercise therapy versus isolated medical exercise therapy for degenerative meniscal tear: A meta-analysis of randomized controlled trials" (Int J Surg. 2020 Jul;79:222-232. doi: 10.1016/j.ijsu.2020.05.035).Int J Surg. 2020 Oct;82:170-171. doi: 10.1016/j.ijsu.2020.07.041. Epub 2020 Sep 2. Int J Surg. 2020. PMID: 32890731 No abstract available.
-
A commentary on "Arthroscopic Partial Meniscectomy Combined With Medical Exercise Therapy Versus Isolated Medical Exercise Therapy for Degenerative Meniscal Tear: A Meta-Analysis of Randomized Controlled Trials" (Int J Surg 2020 Jul; 79: 222-232).Int J Surg. 2020 Oct;82:229-230. doi: 10.1016/j.ijsu.2020.07.070. Epub 2020 Sep 6. Int J Surg. 2020. PMID: 32898665 No abstract available.
-
A commentary on "Arthroscopic partial meniscectomy combined with medical exercise therapy versus isolated medical exercise therapy for degenerative meniscal Tear:…".Int J Surg. 2020 Oct;82:202-203. doi: 10.1016/j.ijsu.2020.07.069. Epub 2020 Sep 6. Int J Surg. 2020. PMID: 32898666 No abstract available.
Similar articles
-
Effectiveness of exercise versus arthroscopic partial meniscectomy plus exercise in the management of degenerative meniscal tears at 5-year follow-up: a systematic review and meta-analysis.Arch Orthop Trauma Surg. 2023 May;143(5):2609-2620. doi: 10.1007/s00402-022-04579-y. Epub 2022 Aug 22. Arch Orthop Trauma Surg. 2023. PMID: 35996030 Review.
-
Medical exercise therapy alone versus arthroscopic partial meniscectomy followed by medical exercise therapy for degenerative meniscal tear: a systematic review and meta-analysis of randomized controlled trials.J Orthop Surg Res. 2020 Jun 15;15(1):219. doi: 10.1186/s13018-020-01741-3. J Orthop Surg Res. 2020. PMID: 32539864 Free PMC article.
-
Long-term effects of exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear: A meta-analysis of randomized controlled trials.Asian J Surg. 2024 Jun;47(6):2566-2573. doi: 10.1016/j.asjsur.2024.03.091. Epub 2024 Mar 25. Asian J Surg. 2024. PMID: 38531745 Review.
-
Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up.BMJ. 2016 Jul 20;354:i3740. doi: 10.1136/bmj.i3740. BMJ. 2016. PMID: 27440192 Free PMC article. Clinical Trial.
-
Arthroscopic lavage and debridement for osteoarthritis of the knee: an evidence-based analysis.Ont Health Technol Assess Ser. 2005;5(12):1-37. Epub 2005 Sep 1. Ont Health Technol Assess Ser. 2005. PMID: 23074463 Free PMC article.
Cited by
-
Comparing Surgical Techniques for Meniscal Tears: A Systematic Review of Radiographic and Functional Outcomes.Cureus. 2023 Dec 28;15(12):e51239. doi: 10.7759/cureus.51239. eCollection 2023 Dec. Cureus. 2023. PMID: 38283492 Free PMC article. Review.
-
Effectiveness of exercise versus arthroscopic partial meniscectomy plus exercise in the management of degenerative meniscal tears at 5-year follow-up: a systematic review and meta-analysis.Arch Orthop Trauma Surg. 2023 May;143(5):2609-2620. doi: 10.1007/s00402-022-04579-y. Epub 2022 Aug 22. Arch Orthop Trauma Surg. 2023. PMID: 35996030 Review.
-
Cost-Effectiveness of Arthroscopic Partial Meniscectomy and Physical Therapy for Degenerative Meniscal Tear.ACR Open Rheumatol. 2022 Oct;4(10):853-862. doi: 10.1002/acr2.11480. Epub 2022 Jul 21. ACR Open Rheumatol. 2022. PMID: 35866194 Free PMC article.
-
No evidence in support of arthroscopic partial meniscectomy in adults with degenerative and nonobstructive meniscal symptoms: a level I evidence-based systematic review.Knee Surg Sports Traumatol Arthrosc. 2023 May;31(5):1733-1743. doi: 10.1007/s00167-022-07040-0. Epub 2022 Jul 1. Knee Surg Sports Traumatol Arthrosc. 2023. PMID: 35776158 Free PMC article. Review.
-
Arthroscopic surgery for degenerative knee disease (osteoarthritis including degenerative meniscal tears).Cochrane Database Syst Rev. 2022 Mar 3;3(3):CD014328. doi: 10.1002/14651858.CD014328. Cochrane Database Syst Rev. 2022. PMID: 35238404 Free PMC article. Review.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources