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Table 2 Evidence for meniscal repair

From: Meniscal pathology - the evidence for treatment

Study Study description Group 1 Group 2 Group 3 Group 4 Outcome measure Results Conclusion
Randomised control trials        
Jarvela and colleagues, 2010 [21] Degenerative meniscal tear or knee OA excluded; 2-year follow-up Screws, n = 21; mean age 30 years (±9 years) Arrows, n = 21; mean age 32 years (±9 years) N/A N/A Surgical failure. Structure No between-group differences for surgical failure rate (P = 0.242). More chondral damage with arrows (P = 0.018) Similar surgical outcomes. Arrows caused more chondral damage
Bryant and colleagues, 2007 [22] Vertical meniscal tears only; 28-month follow-up Sutures, n = 49; mean age 25.7 years (±9 years) Arrows, n = 51; mean age 25.1 years (±8 years) N/A N/A Re-tear rate. Symptoms and quality of life No significant between-group differences for re-tear rate. No significant between-group differences for QOL or WOMET scores No difference between the two different repair methods
Hantes and colleagues, 2006 [23] Those with knee OA at arthroscopy excluded; 23-month follow-up Group A: Outside-in, n = 17 (14 medial meniscus); mean age 28.5 years Group B: Inside-out, n = 20 (17 medial meniscus); mean age 28 years Group C: All-inside, n = 20 (17 medial meniscus); mean age 25 years N/A Operative time and healing rate Healing rate in group C inferior to groups A and B. Group B was quickest procedure Inside-out technique superior to other two as high rate of healing without prolonged operation time
Beidert, 2000 [10] Painful intrasubstance medial meniscal tear; mean age 30.4 years (range 16 to 50 years); 26.5-month follow-up Suture repair, n = 10 PT and NSAIDs, n = 12 Minimal resection, fibrin clot, suture repair, n = 7 APM, n = 11 Symptoms Normal/near normal IKDC. Group 1, 75%; Group 2, 90%; Group 3, 43%; Group 4, 100% Intra-substance (degenerative) meniscal tears were shown to be best treated by APM. Meniscal repair might give better medium-term to long-term results
Albrecht-Olsen and colleagues, 1999 [24] Those with OA at arthroscopy excluded; 3-month to 4-month follow-up Inside-out sutures, n = 32 (21 medial); median age 25.5 years (range 18 to 40 years) All-inside meniscal arrows, n = 33 (21 medial); median age 26.5 years (range 18 to 37 years) N/A N/A Healing rates No between-group differences for healing (P = 0.11). No between-group differences in subgroup analyses, dependent on ACL reconstructed or ACL insufficient knees Similar outcome with two meniscal repair procedures
Cohort studies        
Melton and colleagues, 2011 [27] ACL lesions without degenerative changes; median 10-year follow-up; mean age 28 years (range 20 to 53 years) Inside-out repair, n = 35 (32 medial); mean age 28 years APM, n = 40; mean age 27 years Intact menisci, n = 40; mean age 27 N/A Symptoms Mean IKDC significantly higher in meniscal repair group compared with menisectomy group Improved functional scores achieved in people with ACL reconstruction and meniscal repair compared with ACL reconstruction and menisectomy
Stein and colleagues, 2010 [26] Traumatic meniscal tear; mid-term follow-up at 3.4 years (n = 35); long-term follow-up at 8.8 years (n = 46) Meniscal repair, n = 42; mean age 31.2 APM, n = 39; mean age 30.4 N/A N/A Structure and function Significantly less progression of OA0 (P = 0.005); greater preinjury activity level (P = 0.001) and greater sporting activity among athletes (P = 0.001) in people treated with meniscal repair Meniscal repair associated with better outcomes than APM
Sommerlath, 1991 [25] Baseline symptoms not reported; knee OA excluded; 7-year follow-up Open suture meniscal repair, n = 34; mean age 27 years APM, n = 26; mean age 27 years N/A N/A Symptoms. Structure In meniscal repair group, significantly: higher LKS scores; less OA; longer return to professional activities Reduced OA in meniscal repair group despite longer return to work than people receiving APM
  1. ACL, anterior cruciate ligament; APM, arthroscopic partial menisectomy; N/A, not available; NSAID, nonsteroidal anti-inflammatory drug; OA, osteoarthritis; PT, physical therapy. Western Ontario Meniscal Evaluation Tool (WOMET) is a disease-specific quality-of-life measurement tool for patients with meniscal lesions looking at symptoms (pain, giving way, swelling, stiffness, numbness, loss of motion), sports/recreation/lifestyle/work and emotion. Quality-of-life (QOL) outcome measure consists of 32 items that address each of five separate quality-of-life domains: symptoms and physical complaints, work-related concerns, recreational activities and sports participation, life-style, and social and emotional concerns. Lysholm knee scoring (LKS) scale for knee ligament injuries including pain, swelling, locking, limping, stair climbing, support and squatting. International Knee Documentation Committee score (IKDC) is a score to evaluate knee ligament injuries including three domains of symptoms (pain, locking, catching, swelling, stiffness), sports and daily activities and current knee function (compared with old knee function).