Patient-reported symptoms and changes up to 1 year after meniscal surgery

Abstract

Background and purposeDetailed information on the symptoms and limitations that patients with meniscal tears experience is lacking. This study was undertaken to map the most prevalent self-reported symptoms and functional limitations among patients undergoing arthroscopic meniscal surgery and investigate which symptoms and limitations had improved most at 1 year after surgery.Patients and methodsPatients aged 18–76 years from the Knee Arthroscopy Cohort Southern Denmark (KACS) undergoing arthroscopic meniscal surgery were included in this analysis of individual subscale items from the Knee Injury and Osteoarthritis Outcome Score and 1 question on knee stability. Severity of each item was scored as none, mild, moderate, severe, or extreme. Improvements were evaluated using Wilcoxon’s signed-rank test and effect size (ES).ResultsThe most common symptoms were knee grinding and clicking, knee pain in general, pain when twisting and bending the knee and climbing stairs (88–98%), while the most common functional limitations were difficulty bending to the floor, squatting, twisting, kneeling, and knee awareness (97–99%). Knee pain in general and knee awareness improved most 1 year after meniscal surgery (ES –0.47 and –0.45; p < 0.001), while knee instability and general knee difficulties improved least (ES 0.10 and –0.08; p < 0.006).InterpretationAdults undergoing surgery for a meniscal tear commonly report clinical symptoms and functional limitations related to their daily activities. Moderate improvements were observed in some symptoms and functional limitations and small to no improvement in others at 1 year after surgery. These findings can assist the clinical discussion of symptoms, treatments, and patients’ expectations.

Wild goose chase – no predictable patient subgroups benefit from meniscal surgery: patient-reported outcomes of 641 patients 1 year after surgery

“…Among all available factors in KACS, we considered 26 factors for the prognostic model. These were identified from published literature suggesting an association with outcome after meniscal surgery17 23 24 and/or considered important by orthopaedic surgeons 8 9. Due to a desire to develop a parsimonious prognostic model that could be manageable in clinical practice, eight factors were omitted before model building.…”

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

“…Therefore, our objective was to determine whether cruciate ligament and/or meniscus surgery increased the risk of comorbidities in military service members' injury with or without surgery. We hypothesized that comorbidities would significantly increase in patients who receive surgery because of the small but increased risks for adverse events, 22 as well as temporary reductions in levels of physical activity, 23,24 poor sleep, [25][26][27] and poor nutritional habits, which can occur during the perioperative period; all of which are associated with increased musculoskeletal pain and lifestyle modifications. [28][29][30] These changes in lifestyle can also lead to longterm health consequences 22 and comorbidities, such as mental health disorders and chronic pain conditions.…”

“…We hypothesized that comorbidities would significantly increase in patients who receive surgery because of the small but increased risks for adverse events, 22 as well as temporary reductions in levels of physical activity, 23,24 poor sleep, [25][26][27] and poor nutritional habits, which can occur during the perioperative period; all of which are associated with increased musculoskeletal pain and lifestyle modifications. [28][29][30] These changes in lifestyle can also lead to longterm health consequences 22 and comorbidities, such as mental health disorders and chronic pain conditions. The findings could assist patients in weighing the risk/benefit of surgery versus nonsurgical care, as well as help surgeons identify strategies to reduce comorbidity risk perioperatively.…”

On a Trajectory for Success—9 in Every 10 People With a Degenerative Meniscus Tear Have Improved Knee Function Within 2 Years After Treatment: A Secondary Exploratory Analysis of a Randomized Controlled Trial

“…10 Patients with symptomatic degenerative meniscal tears presenting to clinical practice often report knee pain and functional limitations of moderate to extreme severity. 35,36 In cohort studies, poorer functional performance, lower activity level, larger meniscus excision, meniscal extrusion, and radiographic knee osteoarthritis are prognostic factors for worse outcomes. 9,19,21 These data suggest that there are subgroups of individuals with poor outcomes.U OBJECTIVE: To identify trajectories of patient-reported knee function over 5 years in patients with degenerative meniscal tears, and to explore whether baseline characteristics were associated with trajectories of sport and recreational function.U DESIGN: Prospective cohort study.U METHODS: We conducted a secondary exploratory analysis of the Odense-Oslo Meniscectomy Versus Exercise randomized controlled trial.…”

“…10 Patients with symptomatic degenerative meniscal tears presenting to clinical practice often report knee pain and functional limitations of moderate to extreme severity. 35,36 In cohort studies, poorer functional performance, lower activity level, larger meniscus excision, meniscal extrusion, and radiographic knee osteoarthritis are prognostic factors for worse outcomes. 9,19,21 These data suggest that there are subgroups of individuals with poor outcomes.…”