Factors predicting functional and radiographic outcomes after arthroscopic partial meniscectomy: a review of the literature.
We reviewed articles examining the associations between factors identifiable before or during arthroscopic partial meniscectomy (APM) and functional and radiographic outcomes. We assessed the magnitude of effect and statistical significance of associations between predictor variables and outcomes within each study. We then qualitatively synthesized these observations across multiple studies. Twenty-five studies met our criteria for inclusion. Eight of the studies had a prospective design. There were no randomized, controlled trials. The studies had important methodological limitations. Greater size of meniscal resection and female gender showed the strongest and most consistent associations with greater radiographic evidence of osteoarthritis across multiple studies. Greater articular cartilage degeneration assessed at surgery, greater size of meniscal resection, greater laxity of the anterior cruciate ligament, and prior surgery on the index knee were the strongest predictors of worse functional outcomes. Patients with worse preoperative health status (SF-36 score <60), Workers' Compensation, and pending litigation had worse functional outcomes, but these factors were examined in only 1 study. There was consistently no significant difference in radiographic or functional outcome between medial or lateral meniscal injury. Clinicians should incorporate these predictors of outcome into their conversations with patients regarding the advantages and drawbacks of APM.
Meredith
Dennis S
DS
Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
Losina
Elena
E
Mahomed
Nizar N
NN
Wright
John
J
Katz
Jeffrey N
JN
D005260:Female; D006801:Humans; D008297:Male; D008592:Menisci, Tibial / Q000000981:diagnostic imaging / Q000502:physiology / Q000601:surgery*; D011859:Radiography; D016059:Range of Motion, Articular; D012107:Research Design; D016896:Treatment Outcome