Comparison of Efficacy and Safety Profile of Conservative Versus Surgical Management of Meniscal Injuries


  • Ziyad Ahmad Deprtment of Orthopedic CPSP Student Bacha Khan Medical College Mardan, Pakistan
  • Muhammad Hussain Bacha Khan Medical College Mardan, Pakistan
  • Muhammad Inam Lady Reading Hospital, MTI, Peshawar
  • Muhammad Izhar Harvard Medical School, United States
  • Tariq Ahmad Bacha Khan Medical College Mardan, Pakistan



Background: Surgical management of meniscal tear carries financial implications in resource limited settings like ours. Conservative management could address this issue, if its safety and efficacy profile is better understood.
Objectives: The objective of this study was to compare the efficacy and safety of conservative and surgical management of patients with meniscal tear with conservative management.
Material and Methods: Descriptive comparative study of 80 patients with meniscal tear, recruited through non-probability convenient sampling technique, was carried out at Orthopedic unit MMC MTI Mardan, during 1st August 2022 and 31st July 2023. Patients were assigned to surgical and conservative group. International Knee Documentation Committee (IKDC) score at baseline and 3 months after treatment were compared for efficacy. Treatment related complications were noted.
Results: A total of 80 patients were enrolled with 40 patients in each group (surgical versus conservative). The mean baseline and IKDC score at week 12 in surgical versus conservative group were 45.069±13.301 versus 51.873±17.90 and 79.52±7.40 versus 73.92±11.67 respectively. Surgical group showed treatment response in 37 patients (92.5%) versus 31 (77.5%) in conservative approach (p value 0.060). Surgical site infection was observed in 5 patients (12.5%) in surgical group. Medication related adverse effects were observed in 3 patients (7.5%) in conservative group.
Conclusion: No appreciable differences in the clinical results, such as pain reduction or better knee function, between patients who received meniscal surgery and those who underwent conservative treatment for meniscal tears.
Keywords: Conservative Approach, Meniscal Injury, Surgical Approach, Treatment Outcomes

Author Biography

Muhammad Inam, Lady Reading Hospital, MTI, Peshawar

Associate Professor Dr. Muhammad Inam


Bhan K. Meniscal Tears: Current Understanding, Diagnosis, and Management. Cureus. 2020 Jun 13;12(6):e8590. DOI:

Park JW. Higher Meniscus Surgery Incidence in Korea Compared to Japan or the USA. J Korean Med Sci. 2019 Aug 19;34(32):e233. DOI:

Chambers HG, Chambers RC. The Natural History of Meniscus Tears. J Pediatr Orthop. 2019 Jul; 39(6):S53-S55. DOI:

Doral MN, Bilge O, Huri G, Turhan E, Verdonk R. Modern treatment of meniscal tears. EFFORT Open Rev. 2018 May 21;3(5):260-268. DOI:

Karia M, Ghaly Y, Al-Hadithy N, Mordecai S, Gupte C. Current concepts in the techniques, indications and outcomes of meniscal repairs. Eur J Orthop Surg Traumatol. 2019 Apr;29(3):509-520. DOI: Epub 2018 Oct 29.

Bin SI, Nha KW, Cheong JY, Shin YS. Midterm and Long-term Results of Medial Versus Lateral Meniscal Allograft Transplantation: A Meta-analysis. Am J Sports Med. 2018 Apr;46(5):1243-1250. DOI: Epub 2017 Jun 13.

Berton A, Longo UG, Candela V, Greco F, Martina FM, Quattrocchi CC. Quantitative Evaluation of Meniscal Healing Process of Degenerative Meniscus Lesions Treated with Hyaluronic Acid: A Clinical and MRI Study. J Clin Med. 2020 Jul 17;9(7):22-80. DOI:

Lizaur-Utrilla A, Miralles-Muñoz FA, Gonzalez-Parreño S, Lopez-Prats FA. Outcomes and Patient Satisfaction With Arthroscopic Partial Meniscectomy for Degenerative and Traumatic Tears in Middle-Aged Patients With No or Mild Osteoarthritis. Am J Sports Med. 2019 Aug;47(10):2412-2419. DOI:

Sihvonen R. Meniscal resection may not benefit patients with traumatic meniscal tears. Evid Based Med. 2017 Oct;22(5):193-9. DOI:

Golz AG, Mandelbaum B, Pace JL. All-Inside Meniscus Repair. Curr Rev Musculoskelet Med. 2022 Aug;15(4):252-258. DOI:

Vermesan D, Prejbeanu R, Laitin S, Damian G, Deleanu B, Abbinante A, et al. Arthroscopic debridement compared to intra-articular steroids in treating degenerative medial meniscal tears. Eur Rev Med Pharmacol Sci. 2013 Dec;17(23):3192-6.

Ozeki N, Seil R, Krych AJ, Koga H. Surgical treatment of complex meniscus tear and disease: state of the art. J ISAKOS. 2021 Jan;6(1):35-45. DOI: Epub 2020 Sep 17. PMID: 33833044.

Cavendish PA, Coffey E, Milliron EM, Barnes RH, Flanigan DC. Horizontal Cleavage Tear Meniscal Repair Using All-Inside Circumferential Compression Sutures. Arthrosc Tech. 2023 Jul 10;12(8):e1319-e1327. DOI: PMID: 37654892; PMCID: PMC10466186.

Migliorini F, Schäfer L, Bell A, Weber CD, Vecchio G, Maffulli N. Meniscectomy is associated with a higher rate of osteoarthritis compared to meniscal repair following acute tears: a meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2023 Dec;31(12):5485-5495. DOI: Epub 2023 Oct 9. PMID: 37812251; PMCID: PMC10719156.

Hohmann E. Treatment of Degenerative Meniscus Tears. Arthroscopy. 2023 Apr;39(4):911-912. DOI: PMID: 36872031.

Finger F, Ahrend MD, Ihle C, Histing T, Schröter S. Fallbericht zur Entstehung einer medialen Gonarthrose nach Innenmeniskusläsion underfolgter Teilresektion [MRI case series shows the development of medial gonarthrosis after medial meniscus tear and partial medial meniscectomy]. Unfallchirurgie (Heidelb). 2023 Feb;126(2):161- 167. German. DOI: Epub 2022 Apr 13. PMID: 35416481; PMCID: PMC9898393.

Avila A, Vasavada K, Shankar DS, Petrera M, Jazrawi LM, Strauss EJ. Current Controversies in Arthroscopic Partial Meniscectomy. Curr Rev Musculoskelet Med. 2022 Oct;15(5):336-343. DOI: Epub 2022 Jun 21. PMID: 35727503; PMCID: PMC9463417.

Mesiha M, Zurakowski D, Soriano J, Nielson JH, Zarins B, Murray MM. Pathologic characteristics of the torn human meniscus. Am J Sports Med. 2007 Jan;35(1):103-12. DOI:

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Ziyad Ahmad, Muhammad Hussain, Muhammad Inam, Muhammad Izhar, Tariq Ahmad. Comparison of Efficacy and Safety Profile of Conservative Versus Surgical Management of Meniscal Injuries. J Saidu Med Coll Swat [Internet]. 2024 Mar. 8 [cited 2024 Jul. 12];14(1):3-8. Available from:

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