OBJECTIVE Arthroscopic partial meniscectomy (APM) is one of the most commonly performed surgical procedures. However, the indications for APM are controversial and obese patients may have worse outcomes. This study's primary purpose was to investigate differences in outcome after APM associated with elevated body mass index (BMI). Secondary objectives included differences in pathophysiology, surgical complications/failures, or osteoarthritis development. DESIGN MEDLINE, EMBASE, and OVID databases were systematically searched for eligible studies reporting on APM outcomes at a minimum of 1 year postoperatively. Studies that did not include BMI categorization were excluded. Meta-analysis was conducted with random-effects modeling where data from at least 2 studies was available. RESULTS A total of 16 articles were included. Overweight/obese BMI was associated with worse preoperative Lysholm (mean difference, -6.06 [95% CI, -11.70 to -0.42]) and visual analogue scale pain scores (0.43 [0.07 to 0.79]). Worse postoperative normalized knee-specific patient-reported outcome scores were also associated with obese BMI (-4.57 [-5.33 to -3.81]). There were no significant differences in clinical improvement or osteoarthritis progression among BMI groups. Two studies found higher complication/failure rates, 3 articles associated medial meniscus posterior root tears, and 1 article found differences in gene transcript expression with increased BMI. CONCLUSIONS Obesity is associated with worse knee function after APM, and patients with elevated BMI have worse preoperative knee pain and function. However, there is no difference in amount of improvement between elevated and normal BMI patients. Further prospective research is necessary to determine the comparative effectiveness of APM in patients with elevated BMI.

中文翻译：

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肥胖患者半月板​​部分切除术的结果：系统评价和荟萃分析。

目的关节镜下半月板部分切除术 (APM) 是最常用的外科手术之一。然而，APM 的适应症存在争议，肥胖患者的预后可能更差。本研究的主要目的是调查 APM 后与体重指数 (BMI) 升高相关的结果差异。次要目标包括病理生理学、手术并发症/失败或骨关节炎发展方面的差异。在 DESIGN MEDLINE、EMBASE 和 OVID 数据库中系统地搜索了符合条件的研究报告术后至少 1 年的 APM 结果。不包括 BMI 分类的研究被排除在外。荟萃分析采用随机效应模型进行，其中至少有 2 项研究的数据可用。结果 共纳入 16 篇文章。超重/肥胖 BMI 与更差的术前 Lysholm（平均差，-6.06 [95% CI，-11.70 至 -0.42]）和视觉模拟量表疼痛评分（0.43 [0.07 至 0.79]）相关。较差的术后标准化膝关节特异性患者报告结果评分也与肥胖 BMI 相关（-4.57 [-5.33 至 -3.81]）。BMI组之间的​​临床改善或骨关节炎进展没有显着差异。两项研究发现并发症/失败率更高，3 篇文章与内侧半月板后根撕裂相关，1 篇文章发现基因转录表达与 BMI 增加有关。结论 肥胖与 APM 后膝关节功能恶化相关，BMI 升高的患者术前膝关节疼痛和功能恶化。然而，BMI 升高的患者和 BMI 正常的患者在改善量上没有差异。需要进一步的前瞻性研究来确定 APM 在 BMI 升高患者中的比较有效性。