Comparison of Arthroscopic Partial Meniscectomy to Physical Therapy following Degenerative Meniscus Tears: A Systematic Review and Meta-analysis

Abstract

Objective. To compare the effectiveness of arthroscopic partial meniscectomy (APM) and physical therapy (PT) for degenerative meniscus tears.Method. We conducted a literature search through PubMed, Embase, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov. Randomized controlled trials in adults with degenerative meniscal tears without symptoms of locking were considered for inclusion. Two researchers independently performed the literature search, assessed the risk of bias, and selected eligible studies. The primary outcome was function at different follow-up time points and the secondary outcome was pain at different follow-up time points.Results. We included 6 randomized controlled trials, with a total of 1006 participants, among which 495 were in the APM group and 511 were in the PT group. We found a small benefit in functional outcomes in the APM group until the 12 months follow-up time point (SMD=0.20;95%CI=0.0‐0.33;p=0.002;I2=34%), but no significant differences in function between groups at the 24-month follow-up time point (SMD=0.12;95%CI=−0.04−0.28;p=0.14;I2=28%). There was also small benefit in the APM group until the 12 months follow-up time point for pain (SMD=0.14;95%CI=0.01−027;p=0.03;I2=36%), but no significant difference in pain between groups at 24 months (SMD=0.11;95%CI=−0.05−0.28;p=0.18;I2=0%).Conclusion. In the treatment of degenerative meniscus tears, APM yielded better functional and pain outcomes compared with physical therapy in the short term until 12 months, but there were comparable results for pain and functional outcomes between the groups at the 24 months follow-up time point.