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

• Published in: Physical therapy in sport Vol. 65; pp. 14 - 22
• Main Authors: Falvey, Kyle T., Kinshaw, Chad M., Warren, Gordon L., Tsai, Liang-Ching
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.01.2024; Elsevier Limited
• Subjects: Arthritis; Bias; Biomechanical Phenomena; Biomechanics; Bone surgery; Cohen's d; Gait; Humans; Kinetics; Knee; Knee - physiopathology; Knee Joint; Knee loading; Legs; Meniscectomy; Meniscus; Meta-analysis; Osteoarthritis; Osteoarthritis, Knee - rehabilitation; Osteoarthritis, Knee - surgery; Software; Systematic review; Walking; Meniscus; Kinetics; Osteoarthritis; Knee loading
• ISSN: 1466-853X; 1873-1600; 1873-1600
• DOI: 10.1016/j.ptsp.2023.10.005

To determine the changes in knee flexion moment (KFM) and knee adduction moment (KAM) during weight-bearing activities following meniscectomy. Meta-Analysis. Laboratory. 332 meniscectomy patients and 137 healthy controls (from 13 qualified studies) 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. 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. 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. •The knee adduction moment (KAM) may increase bilaterally in meniscectomy patients.•The surgical knee has a lower knee flexion moment (KFM) than the non-surgical knee.•Reducing bilateral KAM and restoring KFM symmetry may lower OA risk post-meniscectomy.