Knee meniscectomy is the most common procedure performed by orthopaedic surgeons. While it is generally believed that loss of meniscal tissue leads to osteoarthritis and poor knee function, many variables may significantly influence this outcome. Through literature search engines including PubMed and Ovid, 4 randomized controlled trials, 2 prospective cohorts, and 23 retrospective cohorts that fit the criteria for level I, II, and III level of evidence were included in this systematic review. For the level III evidence studies, follow-up of 5 years or more was required. Preoperative and intraoperative predictors of poor clinical or radiographic outcomes included total meniscectomy or removal of the peripheral meniscal rim, lateral meniscectomy, degenerative meniscal tears, presence of chondral damage, presence of hand osteoarthritis suggestive of genetic predisposition, and increased body mass index. Variables that were not predictive of outcome or were inconclusive or had mixed results included meniscal tear pattern, age, mechanical alignment, sex of patient, activity level, and meniscal tears associated with anterior cruciate ligament (ACL) reconstruction. While an intact meniscus or meniscal repair was generally favorable in the ACL-reconstructed knees, meniscal repair of degenerative meniscal tissue was not favorable. There is a lack of uniformity in the literature on this subject with a preponderance of lower level evidence. Although randomized controlled trials are considered to be the gold standard in medical research, a multicenter prospective cohort design may be more appropriate in assessing the long-term outcome of meniscal surgery and the role that multiple preoperative and intraoperative variables may play in clinical outcomes. In addition, future studies should include factors not assessed or adequately evaluated by several of the included studies, such as meniscal tear pattern, age, mechanical alignment, sex of the patient, activity level, meniscal tears associated with other injuries such as the ACL, smoking, and the effect of previous surgery.

Context:Knee injuries, particularly of the medial collateral ligament (MCL), are the most common injury sustained in American football. In 1979, Anderson et al described a knee brace that could protect uninjured knees from MCL injuries resulting from lateral impact. Since then, a number of light and free-moving bracing devices have been developed. However, the efficacy of prophylactic knee bracing remains in question.Objective:A systematic review of the efficacy of prophylactic knee bracing in preventing MCL injuries in football players.Data Sources:Based on MedSearch and PubMed, articles from 1985 to November 2009 were identified with the following keywords and their combinations: prophylactic, prevent injury, knee brace, prevention, medial collateral ligament, MCL, football, and bracing.Study Selection:One randomized controlled trial (level 1 study) and 5 prospective cohort studies (level 2 studies) were selected.Results:The results of the studies were inconsistent; only 1 study showed that prophylactic knee bracing significantly reduced MCL injuries (P < .05). In contrast, 2 studies found that knee bracing was associated with an increase in knee injuries.Conclusions:Prophylactic bracing in American football has not consistently reduced MCL injuries. There remains a lack of evidence to support the routine use of prophylactic knee bracing in uninjured knees. There is limited high-level evidence, bias in the available literature, and confounding variables that limit the current literature.

Context:Unhealthy weight loss practices continue to plague amateur wrestling. The National Collegiate Athletic Association weight loss guidelines are beneficial but have not solved the problem.Evidence Acquisition:All relevant databases through 2008 were searched using PubMed. The references of relevant articles were then searched for additional publications.Study Type:Clinical review.Results:New rules approved by the National Collegiate Athletic Association have been implemented in an attempt to prevent drastic weight loss practices in wrestlers. Although some are effective, such as establishing a minimum wrestling weight and decreasing the period between weigh-ins and actual wrestling, unsafe weight loss practices still occur.Conclusion:The attempts made by the National Collegiate Athletic Association to prevent drastic weight loss in wrestling have been effective to some degree. The mind-set of athletes, coaches, and clinicians needs to change if further improvements are to be made.

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