An Up-to-Date Review of the Meniscus Literature: A Systematic Summary of Systematic Reviews and Meta-analyses

Abstract

Background: A large number of systematic reviews and meta-analyses regarding the meniscus have been published. Purpose: To provide a qualitative summary of the published systematic reviews and meta-analyses regarding the meniscus. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic search of all meta-analyses and systematic reviews regarding the meniscus and published between July 2009 and July 2019 was performed with PubMed, CINAHL, EMBASE, and the Cochrane database. Published abstracts, narrative reviews, articles not written in English, commentaries, study protocols, and topics that were not focused on the meniscus were excluded. The most pertinent results were extracted and summarized from each study. Results: A total of 332 articles were found, of which 142 were included. Included articles were summarized and divided into 16 topics: epidemiology, diagnosis, histology, biomechanics, comorbid pathology, animal models, arthroscopic partial meniscectomy (APM), meniscal repair, meniscal root repairs, meniscal allograft transplantation (MAT), meniscal implants and scaffolds, mesenchymal stem cells and growth factors, postoperative rehabilitation, postoperative imaging assessment, patient-reported outcome measures, and cost-effectiveness. The majority of articles focused on APM (20%), MAT (18%), and meniscal repair (17%). Conclusion: This summary of systematic reviews and meta-analyses delivers surgeons a single source of the current evidence regarding the meniscus.

Treatment of post-meniscectomy knee symptoms with medial meniscus replacement results in greater pain reduction and functional improvement than non-surgical care

“…Evidence from randomized controlled trials (RCT) has suggested that partial meniscectomy may not be superior to non-surgical care alone or sham surgery, but some trials had important study design limitations and high cross-over rates [1,7,27,32,33,35,36]. Nonetheless, expert consensus statements and professional societies recommend partial meniscectomy for patients with irreparable meniscus tears and mechanical knee symptoms that are refractory to at least 3 months of non-surgical care [5,19].…”

How to salvage the delivery of a wrong-sided meniscal allograft: A rare case series

“…The number of meniscal allograft transplantations (MAT) has increased dramatically over the past 5 years. [1] MAT are indicated in patients who are functionally meniscus-deficient to improve outcome by decreasing contact pressures within the joint. [2][3][4] Those treated with MAT have shown improvement in symptoms and function in the mid and long-term.…”

Arthroscopic Repair for Parrot Beak Tear of Lateral Meniscus with Reduction Suture and Inside-Out Technique

“…Partial meniscectomy has been the gold standard for surgical treatment of meniscal tears for many years; it is safe with a low rate of complications and reoperation. 2 However, meniscectomy affects the knee biomechanics, 3 lowers the rate of return to play, 4 and with time could lead to osteoarthritis. 5 Although it was once believed that meniscal tears in the avascular zone, including parrot beak tears, did not possess the capacity to heal, repair of tears in the avascular zone could be clinically beneficial for young patients.…”