Clinical and radiographic results of partial versus total meniscectomy in patients with symptomatic discoid lateral meniscus: A systematic review and meta-analysis

Purpose: Some reports have noted favorable long-term clinical results with milder postoperative arthritic changes after total meniscectomy in symptomatic patients with torn discoid lateral meniscus (DLM). This meta-analysis was conducted to compare the clinical and radiographic results between partial and total meniscectomy in patients with symptomatic DLM. Methods: Studies were included in the meta-analysis if (1) they analysed patients who underwent arthroscopic surgeries for DLMs, (2) they directly compared clinical outcomes in patients treated with partial and total meniscectomies, (3) they analysed at least one parameter related to postoperative outcomes, including the Ikeuchi scale, and/or radiographic results including the Tapper and Hoover classification. Results: Eight studies were finally included. The proportion of the knees with excellent or good grade appeared to be higher in partial than in total meniscectomy group, but this difference did not reach statistical significance [128/158 (81.0%) vs. 87/131 (66.4%); OR 1.62; p = 0.10; I-2 =0%]. The pooled results of the proportion of normal cartilage status or mild chondral wear (grade 0 or 1 of the Tapper and Hoover classification) were significantly much higher with partial than with total meniscectomy [228/261 (87.4%) vs. 94/169 (55.6%); OR 9.08; p < 0.001; I-2 = 57%]. Conclusion: This meta-analysis showed that the radiographic outcomes of DLM were better with partial meniscectomy with or without repair than with total meniscectomy, but their clinical outcomes were similar. The findings thus suggest that meniscal preservation would be a better option than total meniscectomy for symptomatic DLM. (C) 2019 Elsevier Masson SAS. All rights reserved.