RT Journal Article
SR Electronic
T1 Can we predict the clinical outcome of arthroscopic partial meniscectomy? A systematic review
JF British Journal of Sports Medicine
JO Br J Sports Med
FD BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine
SP bjsports-2017-097836
DO 10.1136/bjsports-2017-097836
A1 Susanne M Eijgenraam
A1 Max Reijman
A1 Sita M A Bierma-Zeinstra
A1 Daan T van Yperen
A1 Duncan E Meuffels
YR 2017
UL http://bjsm.bmj.com/content/early/2017/11/27/bjsports-2017-097836.abstract
AB NHS-Prospero registration number 42016048592Objective In order to make a more evidence-based selection of patients who would benefit the most from arthroscopic partial meniscectomy (APM), knowledge of prognostic factors is essential. We conducted a systematic review of predictors for the clinical outcome following APM.Design Systematic reviewData sources Medline, Embase, Cochrane Central Register, Web of Science, SPORTDiscus, PubMed Publisher, Google ScholarInclusion criteria Report an association between factor(s) and clinical outcome; validated questionnaire; follow-up >1 year.Exclusion criteria <20 subjects; anterior cruciate ligament-deficient patients; discoid menisci; meniscus repair, transplantation or implants; total or open meniscectomy.Methods One reviewer extracted the data, two reviewers assessed the risk of bias and performed a best-evidence synthesis.Results Finally, 32 studies met the inclusion criteria. Moderate evidence was found, that the presence of radiological knee osteoarthritis at baseline and longer duration of symptoms (>1 year) are associated with worse clinical outcome following APM. In addition, resecting >50% of meniscal tissue and leaving a non-intact meniscal rim after meniscectomy are intra-articular predictive factors for worse clinical outcome. Moderate evidence was found that sex, onset of symptoms (acute or chronic), tear type or preoperative sport level are not predictors for clinical outcome. Conflicting evidence was found for the prognostic value of age, perioperative chondral damage, body mass index and leg alignment.Summary/conclusion Long duration of symptoms (>1 year), radiological knee osteoarthritis and resecting >50% of meniscus are associated with a worse clinical outcome following APM. These prognostic factors should be considered in clinical decision making for patients with meniscal tears.