Knee extensor muscle strength in middle-aged and older individuals undergoing arthroscopic partial meniscectomy: A systematic review and meta-analysis

OBJECTIVE: People with meniscal tears are at high risk to develop or progress knee osteoarthritis. Knee extensor weakness is considered a risk factor for osteoarthritis and is often reported in these individuals. The purpose of this systematic review and meta-analysis was to investigate knee extensor strength in people undergoing an arthroscopic partial meniscectomy (APM).

METHODS: Six databases (MEDLINE, CINAHL, SportDISCUS, EMBASE, PEDro and AMED) were searched up to June 22(nd) , 2014. Studies that measured knee extensor muscle strength in people aged 30 years and older undergoing APM for a meniscal tear and used either a healthy control group or the contralateral leg to compare knee extensor muscle strength were included. Methodological quality was assessed using guidelines from the Centre for Reviews and Dissemination.

RESULTS: Eleven studies, including predominately males were included (n= 596). A moderate reduction in muscle strength was observed prior to APM compared to controls (SMD: 0.58 (95% CI: 0.04-1.13) and continued up to 6 months post-surgery (SMD range -2.42 to -0.47). There was no difference in muscle strength at 2 years post-APM (SMD: -0.01, (95% CI -0.36-0.35) while a moderate reduction was again apparent at 4 years post-APM (SMD: -0.56, (-1.20-0.08) compared to controls.

CONCLUSIONS: Our findings suggest that middle-aged and older individuals undergoing APM have reduced knee extensor muscle strength in the operated leg compared to control data. As meniscus pathology and knee extensor muscle weakness are risk factors for osteoarthritis these results highlight the clinical importance of addressing muscle weakness in these individuals. This article is protected by copyright. All rights reserved.