P124 - Efficacy of Repair, Partial Meniscectomy, & Nonoperative Management of Meniscus Root Tears: A Systematic Review & Network Meta-Regression
- D. Lee (Rochester, US)
- D. Lee (Rochester, US)
- A. Reinholz (Rochester, US)
- Y. Lu (Chicago, US)
- S. Till (Rochester, US)
- C. Ezuma (Rochester, US)
- D. Saris (Rochester, US)
- C. Camp (Rochester, US)
- A. Krych (Rochester, US)
Abstract
Purpose
To determine the efficacy of root repair, partial meniscectomy, and nonoperative management in patients with meniscus root tears by performing a network meta-analysis.
Methods and Materials
A systematic review of the literature was conducted in Medline, Scopus, and Embase to identify clinical studies published since 2011 that investigated the efficacy of root repair, partial meniscectomy, and nonoperative management in the treatment of meniscus root tears. Patient cohorts were grouped into treatment categories; data collected included patient demographics, patient-reported outcome measures (PROMs), radiographic outcomes, and progression to total knee arthroplasty (TKA). Interventions were compared via arm-based Bayesian network meta-analysis in a random-effects model.
Results
There was a total of 55 studies that met inclusion criteria with a total of 3191 patients (68.5% female). No studies were of level I or level II evidence. Patient age ranged from 18-83 and mean follow-up time ranged from 18 months to 130 months. Among the studies, 465 patients were nonoperatively managed (14.6%), while 1340 underwent meniscal repair (41.9%), and the remaining underwent meniscectomy (n=1386, 43.4%). Meniscal repair was ranked the highest intervention for both improvements in the IKDC score (effect size = 32, 95% CI: 27-35) and the risk of progression to TKA (relative risk (RR) = 0.07, 95% CI: 0.01-0.35).
Conclusion
Findings of the network meta-analysis were significantly constrained by heterogeneity. There is a limited amount of evidence to suggest that meniscal repair can produce the greatest improvement on IKDC score and reduce the risk of progression to TKA.