No subgroup of patients identified benefitted from arthroscopic partial meniscectomy for knee pain, knee function, health-related QoL
TUESDAY, Feb. 7, 2023 (HealthDay News) — Patients with magnetic resonance imaging-confirmed degenerative meniscus tears do not benefit from arthroscopic partial meniscectomy (APM) versus nonsurgical or sham treatment, according to a study published online Jan. 13 in Osteoarthritis and Cartilage.
Stan R. W. Wijn, from the Radboud Institute for Health Sciences in the Netherlands, and colleagues pooled individual participant data from four randomized controlled trials to examine the effectiveness of APM with magnetic resonance imaging-confirmed degenerative meniscus tears compared to nonsurgical or sham treatment. Knee pain, overall knee function, and health-related quality of life at 24 months were assessed as the primary outcomes. The analysis included 605 patients.
The researchers found that at 24-month follow-up, the APM group showed a small improvement over the nonsurgical or sham group on knee pain (2.5 points [95 percent confidence interval, 0.8 to 4.2] and 2.2 points [95 percent confidence interval, 0.9 to 3.6] for the one- and two-stage analyses, respectively). There was no difference between the groups in overall knee function or health-related quality of life. No relevant subgroup of patients was detected that benefitted from APM across all outcomes. Furthermore, no subgroup was identified in generalized linear mixed-model trees.
“We show with this study that there are no smaller groups of patients who you should actually operate on,” Wijn said in a statement. “As far as we are concerned, we should hardly perform any surgery on the meniscus. Only in case of very obvious complaints, such as a locked knee or when stretching the knee is no longer possible.”
One author disclosed ties to a health insurance company; a second author disclosed ties to Pfizer.