Efficacy of Arthroscopic Meniscal Surgery Versus Conservative Management on Knee Pain and Functional Outcomes: A Meta-Analysis of Randomized Controlled Trials
Bibliographic record
Abstract
Knee pain is a prevalent issue among older adults, often resulting from degenerative joint changes, and significantly impacts functionality and quality of life. While arthroscopic meniscal surgery is a common intervention for managing knee pain, its effectiveness compared to conservative treatments remains debated. This meta-analysis aims to compare the efficacy of arthroscopic meniscal surgery versus conservative management in alleviating knee pain and enhancing functional outcomes in patients with degenerative meniscal tears. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) sourced from PubMed, Web of Science, and Scopus. The focus was on studies evaluating knee pain and function in patients aged 40 and older. Primary outcomes included knee pain reduction, measured using scales such as the Knee Injury and Osteoarthritis Outcome Score (KOOS), Visual Analog Scale (VAS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and functional improvement, assessed by scores like the Knee Injury and Osteoarthritis Outcome Score for Activities of Daily Living (KOOS ADL) and Lysholm Knee Scoring Scale (Lysholm). A random-effects model was employed to account for variability across studies, with heterogeneity quantified using I². Nine RCTs, encompassing a total of 1,200 patients, met the inclusion criteria. Pain outcomes indicated similar improvements in both the arthroscopic surgery and conservative management groups. The pooled standardized mean difference (SMD) for pain was -0.01 (95% CI: -0.36 to 0.34). Functional outcomes also showed minimal differences between treatments, with an SMD of -0.04 (95% CI: -0.21 to 0.13). Moderate heterogeneity (I²=70%) was observed, attributed to variations in conservative management protocols and patient characteristics across studies. Arthroscopic meniscal surgery does not offer significant advantages over conservative management in reducing knee pain or improving function in patients with degenerative meniscal tears.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.026 | 0.043 |
| Meta-epidemiology (narrow) | 0.004 | 0.002 |
| Meta-epidemiology (broad) | 0.027 | 0.067 |
| Bibliometrics | 0.007 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.005 | 0.002 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".