Critical Appraisal of a Systematic Review Comparing Surgical and Conservative Therapies in Treating Meniscus Root Tears

Question: Meniscus root tears (MRT) can result in knee cartilage damage and osteoarthritis; there are currently several treatment options available in clinical practice.The published study aimed to address the question of which type of management of MRTs results in better quality of life (QOL) and activities of daily living (ADL) scores: 1. Surgical management of MRT (consisting of surgical repair or partial meniscectomy) versus conservative therapy (medications) 2. Conventional physical therapy (PT) versus multimodal therapy (traditional PT plus manual therapy) or adjunct therapies (conventional PT plus electrostimulation/electromyographic feedback) METHODSDesign.Systematic review of randomized controlled trials (RCT's) and cohort studies on MRT management (surgical or conservative) from various electronic bibliographic databases including PubMed, Ovid, EBSCO and the Physiotherapy Evidence Database in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). 2Population.The population consisted of both males and females of all ages who had experienced a MRT, from any country, in studies published up to April 22, 2023.Exclusion criteria included osteoarthritis of the knee only, knee cartilage degeneration only, surgery other than MRT repair, and meniscus injury with ligament rupture.A total of 546 patients were included across eight (8) cohort studies and three (3) RCT's, screened from a total of 3,837 articles.Intervention/Exposure.MRT surgical repair.Comparator.Conservative therapies (medication, rehabilitation, physical therapy, exercise, manual therapy, orthotic intervention, aerobic exercise program, injection therapy.Multimodal therapy included manual rehabilitation in addition to exercise therapy.Outcome.The primary outcome was comparison of ADL and QOL scores between surgical and conservative management of MRT's.The secondary outcomes included pain, body mass index (BMI), physical functionality, Kellgren and Lawrence (KL) classifications, and Ahlback classifications.Various scoring systems