Change in patient-reported outcomes in patients with and without mechanical symptoms undergoing arthroscopic meniscal surgery: A prospective cohort study

Pihl, Kenneth; Turkiewicz, Aleksandra; Englund, Martin; Lohmander, L. Stefan; Jørgensen, U. G.; Nissen, Nis; Schjerning, Jeppe; Thorlund, Jonas Bloch

doi:10.1016/j.joca.2018.05.004

Cited by 12 publications

(5 citation statements)

References 39 publications

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“…Younger individuals with meniscal pathology who present with mechanical symptoms maintain better long-term outcomes following surgery when compared with those without mechanical symptoms. 36 Others have found variations in outcomes associated with the repair method, suggesting superiority of meniscus repair versus meniscectomy and nonsurgical treatment over a 10-year period. 37 Our data lacked the granularity necessary to reflect the surgical method and the severity of the condition in which surgery was applied.…”

Section: Discussionmentioning

confidence: 99%

Does Surgery for Cruciate Ligament and Meniscus Injury Increase the Risk of Comorbidities at 2 Years in the Military System?

et al. 2021

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This study aims to determine whether surgery for cruciate ligament (anterior or posterior) or meniscus injury increased risks of subsequent comorbidities in beneficiaries of the Military Health System. The study was a retrospective case-control design in which individuals with cruciate or meniscus injuries were divided into two groups (surgery or none). Data were pulled 12 months prior and 24 months following each respective event and presence of comorbidities were compared between the two groups. Bivariate analyses and logistic regression were used to determine if surgery increased the odds of comorbidities. Participants included 1,686 with a cruciate ligament injury (30.1% treated surgically) and 13,146 with a meniscus injury (44.4% treated surgically). Bivariate comparisons of surgery versus nonsurgical treatment found multiple significant differences. After adjusting for covariates, a significant (p < 0.05) protective effect was seen only for meniscus surgery for concussion, insomnia, other mental health disorders, depression, and substance abuse. Surgery had no increased/decreased risk of comorbidities for cruciate ligament injuries. For meniscus injuries, surgery demonstrated a protective effect for six of the comorbidities we assessed. The treatment approach (surgery vs. nonsurgical) did not change the risk of comorbidities in those with a cruciate ligament injury. It is noteworthy that three of the six comorbidities involved mental health disorders. Although the study design does not allow for determination of causation, these findings should compel future prospective study designs that could confirm these findings.

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Section: Discussionmentioning

confidence: 99%

Does Surgery for Cruciate Ligament and Meniscus Injury Increase the Risk of Comorbidities at 2 Years in the Military System?

et al. 2021

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“…However, these patients generally had more symptoms before surgery suggesting larger room for improvement. 36 The same notion for older patients with mechanical symptoms was not confirmed by randomized controlled trials. 17 High-quality prospective cohort studies looking at the predictive ability of different preoperative variables, such as mechanical symptoms, on APM outcome in younger patients would be a first step to understand these changes better.…”

Section: Discussionmentioning

confidence: 99%

Variation in Patient-Reported Outcomes in Young and Old Patients Up to 4 to 6 Years After Arthroscopic Partial Meniscectomy

Tayfur

Pihl

Varnum

et al. 2022

Clinical Journal of Sport Medicine

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To assess the variation in changes in patient-reported outcomes 4 to 6 years after arthroscopic partial meniscectomy (APM). Design: Prospective cohort study. Setting: Orthopedic departments at public hospitals. Patients: Patients (n 5 447) from the Knee Arthroscopy Cohort Southern Denmark undergoing APM. Interventions: All patients underwent APM. Main Outcome Measures: Change in KOOS 4 scores from baseline before surgery to ;5 years (range 4-6 years) after surgery. KOOS 4 is the average aggregated score of 4 of 5 of the Knee injury and Osteoarthritis Outcome Score (KOOS) excluding the activities of daily living subscale (minimal clinical important improvement ;10 points). A mixed linear model adjusted for sex and body mass index was used to assess change from baseline to ;5-year follow-up. Change in KOOS 4 was divided into 5 categories based on change from baseline to ;5-year follow-up: ,0 points, 0 to 9 points, 10 to 19 points, 20 to 29 points, and $30 points. Results: On average, patient-reported outcomes continued to improve from baseline to ;5-year follow-up (mean KOOS 4 change: 26, 95% CI, 24-28). Proportions in the different response groups were ,0 points (12%), 0 to 9 points (13%), 10 to 19 points (16%), 20 to 29 points (19%), and $30 points (40%), with no difference between younger (#40 years, n 5 75) and older (.40 years, n 5 337) patients (P 5 0.898). Conclusions: Patient-reported outcomes on average improved up to ;5 years after APM; however, large variability was observed. The similar variability in younger and older patients questions the assumption that younger patients with traumatic injuries experience larger benefits from APM.

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“…Meniscal knee injuries are common in the adult population [15], and are typically associated with pain and functional limitations [16, 24].…”

Section: Introductionmentioning

confidence: 99%

The translated Danish version of the Western Ontario Meniscal Evaluation Tool (WOMET) is reliable and responsive

Clementsen

Skou

Hansen

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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Change in patient-reported outcomes in patients with and without mechanical symptoms undergoing arthroscopic meniscal surgery: A prospective cohort study

Abstract: Younger patients (≤40 years) with preoperative MS experienced greater improvements after arthroscopic surgery compared to younger patients without MS. Our observational study result needs to be confirmed in randomized trials.

Cited by 12 publications

References 39 publications

Does Surgery for Cruciate Ligament and Meniscus Injury Increase the Risk of Comorbidities at 2 Years in the Military System?

Does Surgery for Cruciate Ligament and Meniscus Injury Increase the Risk of Comorbidities at 2 Years in the Military System?

Variation in Patient-Reported Outcomes in Young and Old Patients Up to 4 to 6 Years After Arthroscopic Partial Meniscectomy

The translated Danish version of the Western Ontario Meniscal Evaluation Tool (WOMET) is reliable and responsive

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