title: Effects of arthroscopic partial meniscectomy on quadriceps strength: a systematic review.
abstract: BACKGROUND
  Arthroscopic partial meniscectomy (APM) after meniscal tear has been widely accepted and associated with quick return to activity. Unfortunately, meniscectomy is associated with risk for knee osteoarthritis, which may be attributed to postsurgical quadriceps weakness. This has important implications, as the quadriceps play a prominent role in knee stabilization and energy attenuation in the lower extremity.
  
  
  OBJECTIVE
  To determine the magnitude of interlimb quadriceps strength deficits in people with unilateral APM by systematically reviewing the current literature.
  
  
  METHODS
  The Web of Knowledge databases were searched on September 22, 2010, using terms meniscus OR meniscectomy AND quadriceps strength OR quadriceps weakness. Included articles were written in English, reporting means and SDs of isokinetic peak torque at 60° and 180°/s for both limbs.
  
  
  RESULTS
  Four articles were included in the final analysis. Effect sizes and 95% confidence intervals (CI) were calculated between limbs for periods less than 1 mo, 1-3 mo, 3-6 mo, and more than 6 mo.
  
  
  CONCLUSIONS
  Homogeneous effect sizes indicate quadriceps weakness in the involved limb. Effects were strong at less than 1 mo (d = -1.01 to -1.62), while weak to strong effects were found for 1-3 mo (d = -0.40 to -8.04) and 3-6 mo (d = -0.40 to -5.11). Weak effects were found at more than 6 mo (d = -0.30 to -0.37). Definitive effects with a CI not crossing zero were found in 65% of the data. Although APM patients return to function within weeks after surgery, prolonged quadriceps strength deficits may increase the risk of knee-joint degeneration. Furthermore, evidence of bilateral dysfunction after unilateral injury may suggest that neuromuscular deficits post-APM are greater than the interlimb differences found in this review. Further research should be conducted to determine the nature of strength deficits and the best methods for restoring strength after APM.
authors.affiliation: Dept of Kinesiology, University of Toledo, Toledo, OH, USA.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: McLeod
authors.forename: Phillip
authors.initials: P
authors.lastname: Gribble
authors.forename: Kate R
authors.initials: KR
authors.lastname: Pfile
authors.forename: Brian G
authors.initials: BG
authors.lastname: Pietrosimone
mesh_terms: D001182:Arthroscopy / Q000379:methods*; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology* / Q000601:surgery; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D008592:Menisci, Tibial / Q000601:surgery*; D053580:Muscle Strength / Q000502:physiology*; D052097:Quadriceps Muscle / Q000503:physiopathology*; D000070600:Tibial Meniscus Injuries; D016896:Treatment Outcome