Summary of findings: APM versus surgical comparators
| Outcome | Endpoint | Participants (RCTs) | Standardised MD (95% CI) | MD (95% CI) | I2 | GRADE quality* |
| (A) All patients (any type of meniscal tear with or without radiographic osteoarthritis) and (B) Patients with any type of meniscal tear in a non-osteoarthritic knee | ||||||
| Pain | Under 6 months | 35 (1 RCT) | 0.26 (−0.41 to 0.93) | (KOOS pain) 5.30 better (−7.89 to 18.49) | NA | ⨁⨁◯◯ Low† |
| 6–12 months | 146 (1 RCT) | 0.08 (−0.24 to 0.41) | 2.00 better (−5.69 to 9.69) | NA | ⨁⨁◯◯ Low† | |
| Over 12 months | 178 (2 RCTs) | 0.29 (−0.40 to 0.99) | 7.28 better (−9.62 to 24.19) | 70% | ⨁◯◯◯ Very low†‡ | |
| Function | Under 6 months | 35 (1 RCT) | 0.07 (−0.60 to 0.73) | (Lysholm scale) 1.36 better (−11.64 to 14.16) | NA | ⨁⨁◯◯ Low† |
| 6–12 months | 146 (1 RCT) | −0.08 (−0.41 to 0.24) | −1.55 worse (−7.95 to 4.66) | NA | ⨁⨁⨁⨁ High | |
| Over 12 months | 178 (2 RCTs) | 0.16 (−0.62 to 0.95) | 3.10 better (−12.03 to 18.43) | 77% | ⨁◯◯◯ Very low† ‡ | |
| Knee-specific QoL | Under 6 months | 35 (1 RCT) | 0.25 (−0.42 to 0.91) | (KOOS QoL) 4.50 better (−7.37 to 16.37) | NA | ⨁⨁◯◯ Low† |
| 6–12 months | 146 (1 RCT) | 0.05 (−0.27 to 0.38) | 1.10 better (−5.64 to 7.84) | NA | ⨁⨁⨁⨁ High | |
| Over 12 months | 178 (2 RCTs) | 0.25 (−0.39 to 0.88) | 6.25 better (−9.69 to 22.18) | 65% | ⨁◯◯◯ Very low†‡ | |
| Generic QoL | Under 6 months | 35 (1 RCT) | 0.37 (−0.30 to 1.04) | (EQ-5D VAS) 0.04 better (−0.03 to 0.12) | NA | ⨁⨁◯◯ Low† |
| 6–12 months | 146 (1 RCT) | 0.23 (−0.09 to 0.56) | 0.02 better (−0.01 to 0.05) | NA | ⨁⨁⨁⨁ High | |
| Over 12 months | 34 (1 RCT) | 0.69 (−0.01 to 1.38) | 0.11 better (0.00 to 0.22) | NA | ⨁⨁◯◯ Low† | |
SMD in function was translated and re-expressed as a MD in the Lysholm Knee Scale, using the SD of 19.4 reported for patients with isolated meniscal tears.79
*GRADE Explanations.41
†Imprecision (very serious): Wide CI including no benefit and potential MCID (benefit).
‡Inconsistency (very serious): High level of heterogeneity (>50%) between studies.
APM, arthroscopic partial meniscectomy; GRADE, Grading of Recommendations Assessment, Development and Evaluation; I2, heterogeneity; KOOS, Knee injury and Osteoarthritis Outcome Score; MD, mean difference; QoL, quality of life; RCT, randomised controlled trial; SMD, standardised mean difference.