PMID- 32522685 OWN - NLM STAT- MEDLINE DCOM- 20201027 LR - 20210218 IS - 1743-9159 (Electronic) IS - 1743-9159 (Linking) VI - 79 DP - 2020 Jul TI - Arthroscopic partial meniscectomy combined with medical exercise therapy versus isolated medical exercise therapy for degenerative meniscal tear: A meta-analysis of randomized controlled trials. PG - 222-232 LID - S1743-9191(20)30418-0 [pii] LID - 10.1016/j.ijsu.2020.05.035 [doi] AB - 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. CI - Copyright (c) 2020 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved. FAU - Pan, Huagang AU - Pan H AD - Department of Orthopedics, Huaihe Hospital, Henan University, Kaifeng, 475000, China. Electronic address: zgr8656@163.com. FAU - Zhang, Peng AU - Zhang P AD - Department of Orthopedics, Huaihe Hospital, Henan University, Kaifeng, 475000, China. FAU - Zhang, Zhaodong AU - Zhang Z AD - Department of Orthopedics, Huaihe Hospital, Henan University, Kaifeng, 475000, China. FAU - Yang, Quan AU - Yang Q AD - Department of Imaging, Huaihe Hospital, Henan University, Kaifeng, 475000, China. LA - eng PT - Comparative Study PT - Journal Article PT - Meta-Analysis PT - Review DEP - 20200606 PL - United States TA - Int J Surg JT - International journal of surgery (London, England) JID - 101228232 SB - IM CIN - Int J Surg. 2020 Oct;82:170-171. PMID: 32890731 CIN - Int J Surg. 2020 Oct;82:229-230. PMID: 32898665 CIN - Int J Surg. 2020 Oct;82:202-203. PMID: 32898666 MH - Adult MH - Arthroscopy/adverse effects/*methods MH - Combined Modality Therapy MH - Exercise Therapy/*methods MH - Humans MH - Meniscectomy/adverse effects/*methods MH - Middle Aged MH - Randomized Controlled Trials as Topic MH - Tibial Meniscus Injuries/*therapy OTO - NOTNLM OT - Arthroscopic partial meniscectomy OT - Medical exercise therapy OT - Meniscal tear OT - Meta-analysis COIS- Declaration of competing interest There is no conflict of interest. EDAT- 2020/06/12 06:00 MHDA- 2020/10/28 06:00 CRDT- 2020/06/12 06:00 PHST- 2020/03/10 00:00 [received] PHST- 2020/05/07 00:00 [revised] PHST- 2020/05/12 00:00 [accepted] PHST- 2020/06/12 06:00 [pubmed] PHST- 2020/10/28 06:00 [medline] PHST- 2020/06/12 06:00 [entrez] AID - S1743-9191(20)30418-0 [pii] AID - 10.1016/j.ijsu.2020.05.035 [doi] PST - ppublish SO - Int J Surg. 2020 Jul;79:222-232. doi: 10.1016/j.ijsu.2020.05.035. Epub 2020 Jun 6.