Persistent altered knee loading in patients with meniscectomy: A systematic review and meta-analysis

Phys Ther Sport. 2024 Jan:65:14-22. doi: 10.1016/j.ptsp.2023.10.005. Epub 2023 Nov 7.

Abstract

Objectives: To determine the changes in knee flexion moment (KFM) and knee adduction moment (KAM) during weight-bearing activities following meniscectomy.

Design: Meta-Analysis.

Setting: Laboratory.

Participants: 332 meniscectomy patients and 137 healthy controls (from 13 qualified studies) MAIN OUTCOME MEASURES: Cohen's d effect sizes (ESs) were calculated to compare KAM and KFM values of the surgical legs to the non-surgical and to healthy control legs.

Results: When compared to healthy controls, meniscectomy patients' surgical legs demonstrated a significantly greater KAM (ES = 0.310; P = 0.002) but no significant difference in KFM (ES = -0.182; P = 0.051). When compared to the patients' non-surgical legs, however, the surgical legs showed no difference in KAM (ES = -0.024; P = 0.716) but a significantly lower KFM (ES = -0.422; P < 0.001). High heterogeneity among study ESs was observed in patients' between-limb comparison for KAM (Q-value = 20.08, P = 0.005; I2 = 65.1%) and KFM (Q-value = 43.96, P < 0.001; I2 = 79.5%). However, no significant differences in study ESs (all P > 0.102) of KFM and KAM were identified when comparing studies with various times post-surgery, weight-bearing tasks, walking speeds, or patient demographics.

Conclusion: Elevated KAM and reduced/asymmetrical KFM observed in meniscectomy patients may contribute to the increased risk of knee OA. Rehabilitation should focus on movement education to restore between-limb KFM symmetry and reduce KAM bilaterally post-meniscectomy.

Keywords: Kinetics; Knee loading; Meniscus; Osteoarthritis.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Biomechanical Phenomena
  • Gait
  • Humans
  • Knee Joint
  • Knee* / physiopathology
  • Meniscectomy*
  • Osteoarthritis, Knee / rehabilitation
  • Osteoarthritis, Knee / surgery
  • Walking