Meniscal repair versus resection: Integrating pain mediator profiles with functional outcomes in a comparative...

Arthroscopic meniscal surgery remains controversial regarding optimal tissue management strategies. While partial meniscectomy provides immediate symptom relief, concerns persist about accelerated joint degeneration. Meniscal repair preserves tissue but requires technical expertise and prolonged rehabilitation. This study aims to comprehensively compare mid-term outcomes between arthroscopic meniscal repair and partial meniscectomy through multidimensional assessment of biochemical, functional, biomechanical, and structural parameters. Arthroscopic meniscal repair demonstrates superior mid-term efficacy compared to partial meniscectomy across all assessed domains. The comprehensive benefits reduced inflammatory burden, enhanced functional recovery, improved biomechanics, and better structural outcomes strongly support tissue preservation strategies. This retrospective comparative study analyzed 108 patients with meniscal injuries (October 2022-October 2024) who underwent either arthroscopic repair (n = 56) or partial meniscectomy (n = 52). Outcomes assessed at 6-month follow-up included serum pain mediators (5-HT, prostaglandin E2, bradykinin) via enzyme-linked immunosorbent assay, functional status using Oxford knee score and Lysholm scale, gait parameters through instrumented analysis, and clinical/magnetic resonance imaging evaluation. Statistical analysis employed Mann-Whitney U test for continuous variables and chi-square tests for categorical variables, with Wilcoxon signed-rank test for paired comparisons (P < .05). Both groups showed comparable baseline characteristics. At 6-month follow-up, the repair group demonstrated significantly lower pain mediator concentrations compared to resection: 5-HT (438.67, interquartile range [IQR] 398.52-485.43 vs 516.51, IQR 465.38-572.84 μg/L, P < .001), prostaglandin E2 (152.79, IQR 131.45-175.38 vs 206.46, IQR 182.74-235.67 pg/mL, P < .001), and bradykinin (8.43, IQR 6.82-10.15 vs 12.51, IQR 9.45-15.83 ng/mL, P < .001). Functional scores favored repair with superior Oxford knee score (14.24, IQR 11.95-16.82 vs 16.32, IQR 13.58-19.24, P = .002) and Lysholm scores (80.39, IQR 74.52-86.94 vs 69.38, IQR 63.48-75.82, P < .001). Effect sizes ranged from 0.65 to 0.92, indicating large clinical differences. Clinical examination positivity rates were markedly lower after repair, with magnetic resonance imaging abnormalities persisting in 17.86% versus 36.54% (P = .029).