Observation Versus Debridement of Unstable Chondral Lesions During Partial Meniscectomy: Analysis of Patient Outcomes and Degenerative Joint Disease at 5 Years in the Chondral Lesions And Meniscus Procedures (ChAMP) Randomized Controlled Trial

Socioeconomic and Demographic Variables Are Lacking in Meniscectomy Randomized Controlled Trials: A Systematic Review

PURPOSE

To evaluate the inclusion of sociodemographic factors in randomized controlled trials (RCTs) on meniscectomy outcomes, with the goal of understanding the extent to which RCTs on meniscectomy consider sociodemographic variables.

METHODS

PubMed, Embase, and MEDLINE were queried from January 1, 2014, to October 10, 2024, for meniscectomy RCTs in high-impact journals. Each RCT was assessed for inclusion of the following background and sociodemographic variables: age, sex, body mass index (BMI), race/ethnicity, education level, insurance, smoking/tobacco use, socioeconomic status, marital status, alcohol use, proficiency in country's official language, employment status, and residence status. Temporal trends were analyzed using the Fisher exact test.

RESULTS

Of 301 RCTs screened, 11 reports on unique meniscectomy trials were included. All 11 studies included age. Sex and BMI were included in 10 studies (90.9%). Patients' proficiency in the official language(s) of the study country was only included in 4 studies (36.4%). Employment status was reported in 2 studies (18.2%), and race/ethnicity and smoking/tobacco use were each included in one study (9.1%). Socioeconomic status, residency status, alcohol use, marital status, and insurance were not reported in any included RCT. There was no significant difference in the reporting of at least 1 sociodemographic variable (excluding age, sex, and BMI) in later studies (2015-2019) versus earlier studies (2020-2024, P = .061).

CONCLUSIONS

Our analysis of high-impact meniscectomy RCTs revealed deficient reporting of sociodemographic variables over the last decade. RCTs investigating meniscectomy outcomes should consistently report key sociodemographic variables to better elucidate the external validity of their findings.

CLINICAL RELEVANCE

This analysis highlights the historical oversight of sociodemographic factors in meniscectomy trials and thus emphasizes the critical need to incorporate these variables in future orthopaedic clinical research to improve the generalizability, utility, and replicability of study findings.

Examining the Evidence Regarding Smoking and Patient Outcomes for Isolated Meniscus Pathology: A Comprehensive Systematic Review and Meta-Analysis

Smoking is a well-known cause of impairment in wound healing and postoperative outcomes; however, its effects on treating meniscus issues remain unclear. This study assesses the relationship between smoking and meniscus treatment outcomes. PubMed, Scopus, Cochrane, and CINAHL were searched from inception to 24 December 2023. Inclusion criteria encompassed studies examining smoking's impact on patient outcomes regarding meniscus pathology. A secondary PubMed search targeted randomized controlled trials (RCTs) in the top ten orthopedic journals focusing on meniscus pathology and smoking as a demographic variable. Meta-analysis of six studies (n = 528) assessed meniscus failure rate based on smoking status. Eighteen observational studies (n = 8353 patients; 53.25% male; mean age: 51.35 ± 11.53 years; follow-up: 184.11 ± 117.34 months) were analyzed, covering meniscus repair, meniscectomy, allograft transplant, conservative care, and arthroscopy. Results showed four studies (36.36%) linked smoking with worse meniscus repair outcomes, while seven studies (63.64%) did not find significant associations. Meta-analysis from six studies showed no significant impact of smoking on repair failure (p = 0.118). Regarding meniscectomy, one study (33.33%) identified a significant association with smoking, but two did not. Only one (3.8%) of the RCTs in leading orthopedic journals included smoking as a factor. The evidence on smoking's effect on meniscus treatment is mixed, necessitating further investigation.