Skip to main content

Main menu

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2021
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2021
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
Research

Arthroscopic surgery for degenerative tears of the meniscus: a systematic review and meta-analysis

Moin Khan, Nathan Evaniew, Asheesh Bedi, Olufemi R. Ayeni and Mohit Bhandari
CMAJ October 07, 2014 186 (14) 1057-1064; DOI: https://doi.org/10.1503/cmaj.140433
Moin Khan
Division of Orthopaedic Surgery (Khan, Evaniew, Ayeni, Bhandari), Department of Surgery, McMaster University, Hamilton, Ont.; MedSport, Department of Orthopaedic Surgery (Bedi), University of Michigan, Ann Arbor, Mich.; Department of Clinical Epidemiology and Biostatistics (Bhandari), McMaster University, Hamilton, Ont.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: moinkhanmd@gmail.com
Nathan Evaniew
Division of Orthopaedic Surgery (Khan, Evaniew, Ayeni, Bhandari), Department of Surgery, McMaster University, Hamilton, Ont.; MedSport, Department of Orthopaedic Surgery (Bedi), University of Michigan, Ann Arbor, Mich.; Department of Clinical Epidemiology and Biostatistics (Bhandari), McMaster University, Hamilton, Ont.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Asheesh Bedi
Division of Orthopaedic Surgery (Khan, Evaniew, Ayeni, Bhandari), Department of Surgery, McMaster University, Hamilton, Ont.; MedSport, Department of Orthopaedic Surgery (Bedi), University of Michigan, Ann Arbor, Mich.; Department of Clinical Epidemiology and Biostatistics (Bhandari), McMaster University, Hamilton, Ont.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Olufemi R. Ayeni
Division of Orthopaedic Surgery (Khan, Evaniew, Ayeni, Bhandari), Department of Surgery, McMaster University, Hamilton, Ont.; MedSport, Department of Orthopaedic Surgery (Bedi), University of Michigan, Ann Arbor, Mich.; Department of Clinical Epidemiology and Biostatistics (Bhandari), McMaster University, Hamilton, Ont.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Mohit Bhandari
Division of Orthopaedic Surgery (Khan, Evaniew, Ayeni, Bhandari), Department of Surgery, McMaster University, Hamilton, Ont.; MedSport, Department of Orthopaedic Surgery (Bedi), University of Michigan, Ann Arbor, Mich.; Department of Clinical Epidemiology and Biostatistics (Bhandari), McMaster University, Hamilton, Ont.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Tables
  • Related Content
  • Metrics
  • Responses
  • PDF
Loading

Abstract

Background: Arthroscopic surgery for degenerative meniscal tears is a commonly performed procedure, yet the role of conservative treatment for these patients is unclear. This systematic review and meta-analysis evaluates the efficacy of arthroscopic meniscal débridement in patients with knee pain in the setting of mild or no concurrent osteoarthritis of the knee in comparison with nonoperative or sham treatments.

Methods: We searched MEDLINE, Embase and the Cochrane databases for randomized controlled trials (RCTs) published from 1946 to Jan. 20, 2014. Two reviewers independently screened all titles and abstracts for eligibility. We assessed risk of bias for all included studies and pooled outcomes using a random-effects model. Outcomes (i.e., function and pain relief) were dichotomized to short-term (< 6 mo) and long-term (< 2 yr) data.

Results: Seven RCTs (n = 805 patients) were included in this review. The pooled treatment effect of arthroscopic surgery did not show a significant or minimally important difference (MID) between treatment arms for long-term functional outcomes (standardized mean difference [SMD] 0.07, 95% confidence interval [CI] −0.10 to 0.23). Short-term functional outcomes between groups were significant but did not exceed the threshold for MID (SMD 0.25, 95% CI 0.02 to 0.48). Arthroscopic surgery did not result in a significant improvement in pain scores in the short term (mean difference [MD] 0.20, 95% CI −0.67 to 0.26) or in the long term (MD −0.06, 95% CI −0.28 to 0.15). Statistical heterogeneity was low to moderate for the outcomes.

Interpretation: There is moderate evidence to suggest that there is no benefit to arthroscopic meniscal débridement for degenerative meniscal tears in comparison with nonoperative or sham treatments in middle-aged patients with mild or no concomitant osteoarthritis. A trial of nonoperative management should be the first-line treatment for such patients.

View Full Text
PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 186 (14)
CMAJ
Vol. 186, Issue 14
7 Oct 2014
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Arthroscopic surgery for degenerative tears of the meniscus: a systematic review and meta-analysis
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Arthroscopic surgery for degenerative tears of the meniscus: a systematic review and meta-analysis
Moin Khan, Nathan Evaniew, Asheesh Bedi, Olufemi R. Ayeni, Mohit Bhandari
CMAJ Oct 2014, 186 (14) 1057-1064; DOI: 10.1503/cmaj.140433

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Arthroscopic surgery for degenerative tears of the meniscus: a systematic review and meta-analysis
Moin Khan, Nathan Evaniew, Asheesh Bedi, Olufemi R. Ayeni, Mohit Bhandari
CMAJ Oct 2014, 186 (14) 1057-1064; DOI: 10.1503/cmaj.140433
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • Methods
    • Results
    • Interpretation
    • Footnotes
    • References
  • Figures & Tables
  • Related Content
  • Responses
  • Metrics
  • PDF

Related Articles

  • Highlights
  • PubMed
  • Google Scholar

Cited By...

  • Arthroscopic partial meniscectomy for meniscal tears of the knee: a systematic review and meta-analysis
  • Lower nationwide rates of arthroscopic procedures in 2016 compared with 1997 (634925 total arthroscopic procedures): has the tide turned?
  • Arthroscopic meniscectomy versus non-surgical or sham treatment in patients with MRI confirmed degenerative meniscus lesions: a protocol for an individual participant data meta-analysis
  • Wild goose chase - no predictable patient subgroups benefit from meniscal surgery: patient-reported outcomes of 641 patients 1 year after surgery
  • Infographic. Exercise therapy for meniscal tears: evidence and recommendations
  • Changes in the rate of publicly financed knee arthroscopies: an analysis of data from the Norwegian patient registry from 2012 to 2016
  • Risk factors, diagnosis and non-surgical treatment for meniscal tears: evidence and recommendations: a statement paper commissioned by the Danish Society of Sports Physical Therapy (DSSF)
  • Can we predict the clinical outcome of arthroscopic partial meniscectomy? A systematic review
  • Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline
  • Indications for and clinical procedures resulting from magnetic resonance imaging of the knee in older patients: Are we choosing wisely?
  • Arthroscopic partial meniscectomy versus placebo surgery for a degenerative meniscus tear: a 2-year follow-up of the randomised controlled trial
  • Management of osteoarthritis of the knee in younger patients
  • Study protocol for a randomised controlled trial of meniscal surgery compared with exercise and patient education for treatment of meniscal tears in young adults
  • Knee arthroscopy versus conservative management in patients with degenerative knee disease: a systematic review
  • The knee meniscus: management of traumatic tears and degenerative lesions
  • Degenerative meniscus tears - assimilation of evidence and consensus statements across three continents: state of the art
  • Structural pathology is not related to patient-reported pain and function in patients undergoing meniscal surgery
  • Cost-effectiveness of Early Surgery versus Conservative Treatment with Optional Delayed Meniscectomy for Patients over 45 years with non-obstructive meniscal tears (ESCAPE study): protocol of a randomised controlled trial
  • Arthroscopic surgery for knee pain: a highly questionable practice without supporting evidence of even moderate quality
  • Return to Work and Sport Following High Tibial Osteotomy: A Systematic Review
  • Arthroscopic surgery for knee pain
  • The role for arthroscopic partial meniscectomy in knees with degenerative changes: a systematic review
  • The evidence base for orthopaedics and sports medicine: scandalously poor in parts
  • Viscosupplementation in Knee Osteoarthritis: Evidence Revisited
  • Return to sport after open and microdiscectomy surgery versus conservative treatment for lumbar disc herniation: a systematic review with meta-analysis
  • Cost-effectiveness analysis of arthroscopic surgery compared with non-operative management for osteoarthritis of the knee
  • Arthroscopic surgery for degenerative knee: systematic review and meta-analysis of benefits and harms
  • Arthroscopic surgery for degenerative knee: Overused, ineffective, and potentially harmful
  • Knee arthroscopy: influence of systems for delivering healthcare on procedure rates
  • Arthroscopic surgery for degenerative knee
  • Arthroscopic surgery for degenerative knee: systematic review and meta-analysis of benefits and harms
  • Femoroacetabular impingement surgery: are we moving too fast and too far beyond the evidence?
  • Special tests for assessing meniscal tears within the knee: a systematic review and meta-analysis
  • A more correct interpretation
  • Large regional differences in incidence of arthroscopic meniscal procedures in the public and private sector in Denmark
  • The evidence base for orthopaedics and sports medicine
  • Google Scholar

More in this TOC Section

  • Association between antihypertensive medications and risk of skin cancer in people older than 65 years: a population-based study
  • Effectiveness of intrapartum fetal surveillance to improve maternal and neonatal outcomes: a systematic review and network meta-analysis
  • Burden of noninfluenza respiratory viral infections in adults admitted to hospital: analysis of a multiyear Canadian surveillance cohort from 2 centres
Show more Research

Similar Articles

Collections

  • Topics
    • Rheumatology
    • Orthopedic surgery

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions

Copyright 2021, CMA Joule Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

To receive any of the resources on this site in an accessible format, please contact us at cmajgroup@cmaj.ca.

Powered by HighWire