Purpose
To identify factors that affect patient-reported outcome measures (PROMs) and failure
rates after arthroscopic meniscal repair.
Methods
Embase, Embase Classic, and MEDLINE were searched on August 7, 2015, December 23,
2016, and March 11, 2018, for factors associated with PROMs and failure rates after
arthroscopic meniscal repair. We excluded studies that (1) were non–English language,
(2) did not use human patients, (3) were nonclinical, (4) did not analyze for factors
that predicted PROMs or failure rates, and (5) were below Level IV evidence. Studies
were graded into higher and lower quality using the Downs and Black scale.
Results
A total of 34 articles met our criteria, and 32 were graded. We identified 16 articles
as higher quality. Among higher-quality studies, factors that significantly predicted
reduced failure rates were concurrent anterior cruciate ligament reconstruction (ACLR)
(n = 6) and reduced tear complexity (n = 4). Factors that did not significantly impact
failure rates were side of repair (n = 8), sex (n = 7), time from injury to surgery
(n = 7), age (n = 7), rim width (n = 6), and tear length (n = 5). Factors predicting
better PROMs were time from injury to surgery of less than 3 months (n = 1), Outerbridge
scores below grade 3 or 4 (n = 2), and reduced varus alignment (n = 2). Factors that
did not significantly impact PROMs were equipment used (n = 3) and concurrent ACLR
(n = 1).
Conclusions
Factors affecting failure rates and PROMs after arthroscopic meniscal repair were
identified. However, more and higher-quality studies supported concurrent ACLR and
less complex tears as predictors of lower failure rates. PROMs were negatively affected
by a longer time from injury to surgery, higher Outerbridge scores, and greater varus
alignment before surgery.
Level of Evidence
Level IV, systematic review of Level II to IV studies.
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Article info
Publication history
Accepted:
June 16,
2019
Received:
December 12,
2017
Footnotes
The authors report the following potential conflicts of interest or sources of funding: D.Y.T.Y. received support from Sydney Orthopaedic Research Institute for travel to present study at a conference. D.A.P. receives support from Arthrex. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
The views expressed in this article are those of the authors and not the official position of the Sydney Orthopaedic Research Institute.
Identification
Copyright
Crown Copyright © 2019 Published by Elsevier on behalf of the Arthroscopy Association of North America. All rights reserved.
