Meniscectomy vs Meniscal Repair: Comparing Rates of Readmission, Reoperation, and Osteoarthritis.

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Abstract

Conflict of interest statement: One or more of the authors has declared the following potential conflict of interest or source of funding: R.M.P. is a consultant for Smith & Nephew. L.N. and S.D. are employees of Smith & Nephew. S.L.S. has received consulting fees from Smith & Nephew, Linvatec Corporation, Vericel Corporation, Flexion Therapeutics Inc, Ceterix Orthopaedics, Joint Restoration Foundation, Olympus America, Bioventus LLC, LifeNet Health, Kinamed Inc, Pacira Therapeutics Inc; royalties from Linvatec Corporation and ConMed Corporation; honoraria from Vericel Corporation, Flexion Therapeutics, and Joint Restoration Foundation; a grant from Linvatec Corporation; speaking and travel fees from Arthrex and Synthes GmbH; support for education from Elite Orthopedics and Evolution Surgical; and hospitality payments from Aesculap Biologics and Stryker Corporation. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. 6. Knee Surg Sports Traumatol Arthrosc. 2019 Nov;27(11):3441-3452. doi: 10.1007/s00167-019-05389-3. Epub 2019 Feb 4. Anterior cruciate ligament reconstruction with concomitant meniscal surgery: a systematic review and meta-analysis of outcomes. Sarraj M(1), Coughlin RP(2), Solow M(3), Ekhtiari S(2), Simunovic N(2), Krych AJ(4), MacDonald P(5), Ayeni OR(6)(7). Author information: (1)DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada. (2)Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada. (3)St. George's University, University Centre Grenada, West Indies, Grenada. (4)Department of Orthopedic Surgery and the Sports Medicine Center, Mayo Clinic and Mayo Foundation, Rochester, MN, USA. (5)Department of Surgery, University of Manitoba, Winnipeg, MB, Canada. (6)Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada. ayenif@mcmaster.ca. (7)Department of Health Research Methods, Evidence, and Impact, McMaster University Medical Centre, 1200 Main St W, Room 4E15, Hamilton, ON, L8N 3Z5, Canada. ayenif@mcmaster.ca. Erratum in Knee Surg Sports Traumatol Arthrosc. 2019 Nov;27(11):3453. doi: 10.1007/s00167-019-05409-2. PURPOSE: The aim of this review was to compare the clinical outcomes of anterior cruciate ligament reconstruction (ACLR) with either meniscal repair or meniscectomy for concomitant meniscal injury. The primary hypothesis was that short-term clinical outcomes (≤ 2-year follow-up) for ACLR concomitant with either meniscal repair or resection would be similar. The secondary hypothesis was that ACLR with meniscal repair would result in better longer term outcomes compared with meniscal resection. METHODS: The authors searched two online databases (EMBASE and MEDLINE) from inception until March 2018 for the literature on ACLR and concurrent meniscal surgery. Two reviewers systematically screened studies in duplicate, independently, and based on a priori criteria. Quality assessment was also performed in duplicate. The Knee injury and Osteoarthritis Outcome Score (KOOS) sub-scale scores at 2 years post-operatively were combined in a meta-analysis of proportions using a random-effects model. RESULTS: Of 2566 initial studies, 25 studies satisfied full-text inclusion criteria. Mean follow-up was 2.09 years, with a total sample of 37,087 subjects including controls. The meta-analysis demonstrated equivocal results at 2 years, except for KOOS symptom scores which favoured meniscal resection over repair. Mean KT-1000 side-to-side difference (SSD) scores were 1.51 ± 0.60 mm for meniscal repair, 1.96 ± 0.36 mm for meniscal resection, and 1.58 ± 0.20 for control patients (isolated ACLR). Medial meniscal repair showed decreased anterior knee joint laxity compared to medial meniscal resection (P