When Is Meniscus Surgery Needed, An Unsuccessful Search

Yesterday, I talked about the search strategy the authors of Evidence Based Orthopedics* to answer other questions about knee surgery. Today, I’ll use a similar strategy to see if I can find articles on when  surgery is needed for meniscus injury.

So I searched the Cochrane Database of Systemic Reviews using the terms “meniscus” AND “knee” AND “surgery”.

A total of 13 records came up. Only two were relevant.

The first is Surgical interventions for treating meniscal injuries of the knee in adults
Eduard LAR Mutsaerts, Michel PJ van den Bekerom, Jakob de Vries, Jos Bramer, C N van Dijk, Gino MMJ Kerkhoffs June 2010. This  is a protocol with no abstract. It is available only to subscribers of Wiley Online

The second is  “Surgical treatment for meniscal injuries of the knee in adults” Jonathan R Howell, Helen HG Handoll January 2009. This review has been withdrawn and so the abstract is not available. The review itself along with the reason for its withdrawl is available online but again is available only to subscribers of Wiley Online.

So next I searched PubMed (www.ncbi.nlm.nih.gov/pubmed/) clinical queries/systemic reviews: “meniscus” and there were over five thousand records.

So next I filtered the records limiting it to free full text articles by most recent publication. Almost 600 articles were returned. I reviewed the first two hundred and the two below were the only ones that appeared relevant.

The first that appeared relevant was “Meniscus Repair and Reconstruction” 2010 available at
http://www.ncbi.nlm.nih.gov/pubmed/20632982.

Next was “MRI follow-up of conservatively treated meniscal lesions in general practice” 2010 available at http://www.ncbi.nlm.nih.gov/pubmed/20632982.

I next filtered the records for “meniscus” to include only review articles listed by most recent publication. There are 511 reviews returned. On reviewing the first one hundred, fifteen articles appeared potentially relevant. But on reviewing abstracts, they did not appear helpful to a patient trying to decide if he or she needed meniscus surgery.

Finally, I visited the DARE database at http://www.crd.york.ac.uk/crdweb/AboutDare.asp and did a search on “meniscus”. Thirteen articles came up. Only one  appeared relevant and that was the Cochrane article discussed above, “Surgical Treatment for Meniscal Injuries in Adults”. No results were found on the site for the terms “meniscus surgery” or “meniscus injury.

The American Academy of Orthopedic Surgeons website at http://www.aaos.org/research/guidelines/guide.asp was evaluated. Currently there are no guidelines on knee surgery.

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