Clinical Outcomes of Exercise Rehabilitation for Degenerative Tibial Meniscal Tears: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Sujie Mao,1 Kaiwen Xiao,2 Hong Xu,3 YanAn Wang,4 Xiujin Guo2 1Graduate Department, Harbin Sport University, Harbin, Heilongjiang, People’s Republic of China; 2School of Sports Industry and Leisure, Nanjing Sport Institute, Nanjing, Jiangsu, People’s Republic of China; 3College of Sports and Health, Sangmyung University, Seoul, South Korea; 4Academic Affairs Office, Jiangsu Police College, Nanjing, Jiangsu, People’s Republic of ChinaCorrespondence: Xiujin Guo, Nanjing Sport Institute, No. 8, Linggu Temple, XuanWu District, Nanjing, Jiangsu, People’s Republic of China, Email [email protected]: This study aims to comprehensively evaluate the effectiveness of exercise rehabilitation therapy for patients with Degenerative Meniscal Lesions of the Tibia (DMLT), providing more effective and safer treatment options for DMLT patients and offering more reliable evidence-based medical recommendations.Methods: Adhering to the PRISMA guidelines, this research conducted a literature search through databases such as PubMed, Web of Science, EMBASE, EBSCOhost, and Cochrane, with the search cut-off date being January 2024. Following the PICOS principles, a comprehensive search was conducted. Two researchers independently screened the literature and extracted data. Using R software, effect size analyses were conducted on indicators such as pain, knee joint function, lower limb muscle strength, and physical function in DMLT patients, with the significance level set at P< 0.05, aiming to comprehensively assess the impact of exercise therapy on the rehabilitation outcomes for DMLT patients.Results: The study included 12 randomized controlled trials, encompassing 1336 DMLT patients. Based on the quality assessment using the modified Jadad scale, the overall quality of the included studies was determined to be moderate.The meta-analysis showed that exercise therapy significantly reduced pain (WMD=− 5.50, P< 0.05), improved lower limb muscle strength (SMD=0.05, P< 0.05), and enhanced physical function (SMD=0.65, P< 0.05). Subgroup analyses revealed that, compared to surgery alone, exercise therapy combined with surgery had a significant effect on improving muscle strength and physical function. Functional training and home-based exercises showed more pronounced effects on specific indicators. The study results indicate that exercise therapy alone has limited effectiveness in improving knee joint function, and combining exercise with surgery does not show a significant advantage (P > 0.05). Additionally, subgroup analysis revealed no significant impact of intervention duration, exercise type, or patient age on functional improvement.Conclusion: Exercise therapy has shown potential in alleviating pain, enhancing lower limb muscle strength, and improving mobility in patients with degenerative meniscal lesions of the tibia (DMLT). Functional training and varied rehabilitation exercises may provide effective pathways for long-term recovery in these patients.Registration: This study has been registered in a prospective registry platform with the registration number: CRD42024518643.Keywords: degenerative meniscus injury, exercise rehabilitation, non-pharmacological treatment, pain