Background:
Patient-reported outcome measures are commonly used to measure knee pain and
functional impairment. When structural abnormality is identified on
examination and imaging, arthroscopic partial meniscectomy and chondroplasty
are commonly indicated for treatment in the setting of pain and decreased
function.
Purpose:
To evaluate the relationship between patient characteristics, mental health,
intraoperative findings, and patient-reported outcome measures at the time
of knee arthroscopy.
Study Design:
Cross-sectional study; Level of evidence, 3.
Methods:
Between February 2015 and October 2016, patients aged 40 years and older who
were undergoing routine knee arthroscopy for meniscal and cartilage
abnormality, without reconstructive or restorative procedures, were
prospectively enrolled in this study. Routine demographic information was
collected, and the Knee injury and Osteoarthritis Outcome Score (KOOS) Pain,
Quality of Life (QoL), and Physical Function Short Form (PS) subscales and
the mental and physical component subscales of the Veterans RAND 12-Item
Health Survey (VR-12 MCS and VR-12 PCS) were administered preoperatively on
the day of surgery. Intraoperative findings were collected in a standardized
format. Patient demographics, intraoperative findings, and the VR-12 MCS
were used as predictor values, and a multivariate analysis was conducted to
assess for relationships with the KOOS and VR-12 as dependent variables.
Results:
Of 661 eligible patients, baseline patient-reported outcomes and surgical
data were used for 638 patients (97%). Lower scores on both subscales of the
VR-12 were predicted by female sex, positive smoking history, fewer years of
education, and higher body mass index (BMI). All KOOS subscales were
negatively affected by lower VR-12 MCS scores, female sex, lower education
level, and higher BMI in a statistically meaningful way. Positive smoking
history was associated with worse scores on the KOOS-PS. Abnormal synovial
status was associated with worse KOOS-Pain.
Conclusion:
The demographic factors of sex, smoking status, BMI, and education level had
an overwhelming impact on preoperative KOOS and VR-12 scores. Of interest,
mental health as assessed by the VR-12 MCS was also a consistent predictor
of KOOS scores. The only intraoperative finding with a significant
association was abnormal synovial status and its effect on KOOS-Pain
scores.
