Predictive Factors and Duration to Return to Sport After Isolated Meniscectomy

Agarwalla, Avinesh; Gowd, Anirudh K.; Liu, Joseph N.; Lalehzarian, Simon P.; Christian, David R.; Cole, Brian J.; Forsythe, Brian; Verma, Nikhil N.

doi:10.1177/2325967119837940

Cited by 18 publications

(20 citation statements)

References 42 publications

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“…In the current study, we included 204 nonathletes. The mean time to RTA was 3.3 months, which was longer than those reported by Agarwalla et al 2 (2 months) and Lee et al 19 (7-9 weeks). This difference may be explained by the fact that rehabilitation centers are not as common in China as in Western countries; thus, when patients have knee-related symptoms, they are less likely to ask physical therapists for help, which may hinder the rehabilitation process.…”

Section: Discussioncontrasting

confidence: 52%

“…However, there are many more nonathletes with meniscal injuries than athletes. Agarwalla et al 2 included 94 nonathletes in their study and found that a higher preoperative KOOS was associated with an increased rate of return to sports. However, the small sample size of their study may have weakened its statistical power.…”

Section: Discussionmentioning

confidence: 99%

“…However, in the study, only professional soccer players were included. In another study, 2 the authors concluded that approximately 77% of patients who underwent partial meniscectomy returned to play at a mean of 2 months postoperatively, and higher preoperative Knee injury and Osteoarthritis Outcome Score (KOOS) for pain was associated with the time of return to sports.…”

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confidence: 99%

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Predictive Factors Associated With Short-Term Clinical Outcomes and Time to Return to Activity After Arthroscopic Partial Meniscectomy in Nonathletes

Wang

Lin

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Although arthroscopic partial meniscectomy is a widely implemented surgical procedure, studies investigating the time to return to activity (RTA) are rare. Purpose: To explore which factors are associated with the RTA times after arthroscopic partial meniscectomy and to investigate whether those factors can also improve short-term patient-reported outcomes. Study Design: Case-control study; Level of evidence, 3. Methods: The authors reviewed the records of patients who underwent isolated partial meniscectomy in their institution from January 2017 to December 2019. Patient and injury characteristics were documented, and time to RTA was obtained via phone interview in January 2021. Pre- and postoperative outcomes were assessed with the Lysholm score and International Knee Documentation Committee (IKDC) score. The chi-square test and independent-samples t test were used to evaluate differences in outcome scores and time to RTA according to the patient and injury characteristics, and risk factors with a P value <.1 in the univariate analysis were used in the binary regression. Results: Included were 215 patients (87 men and 128 women; mean age, 33.7 years [range, 24-75 years]). Of these patients, 204 provided information on time to RTA (mean, 3.3 months). By 3 months postoperatively, 49.5% (101/204) of patients could perform activities without knee-related restriction; this improved to 69.6% (142/204) at 6 months and 90.2% (184/204) at 12 months. On multivariate logistic regression analysis, age (OR, 0.39; 95% CI, 0.21-1.19; P = .044) and injury duration (OR, 0.20; 95% CI, 0.19-1.07; P = .032) were significantly associated with the time to RTA. IKDC scores improved significantly from 41.2 preoperatively to 76.7 postoperatively, and in the multivariate logistic regression model, female sex (OR, 2.67; 95% CI, 1.10-6.47; P = .030), body mass index (BMI) ≥27 kg/m2 (OR, 2.96; 95% CI, 1.02-8.66; P = .047), and medial meniscal tear (OR, 0.20; 95% CI, 0.04-1.00; P = .050) were associated with inferior outcome scores. Conclusion: Patients aged 40 years and younger who underwent partial meniscectomy surgery within 6 months after a meniscal tear were more likely to have a shorter time to RTA, and female patients with obesity (BMI ≥27 kg/m2), especially those with medial meniscal tears, tended to have inferior clinical outcomes.

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Section: Discussioncontrasting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Predictive Factors Associated With Short-Term Clinical Outcomes and Time to Return to Activity After Arthroscopic Partial Meniscectomy in Nonathletes

Wang

Lin

et al. 2022

Orthopaedic Journal of Sports Medicine

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“… 17 Body mass index greater than 25, lateral meniscal tears, tear pattern, and concomitant knee instability have been associated with poorer postoperative outcomes in a general population. 1 , 8 , 23 , 26 , 31 To the best of the authors’ knowledge, there has been only 1 other report of factors associated with RTP specific to elite soccer athletes. 23 Despite the well-established prevalence of meniscal injuries in soccer players, 20 there remains a notable gap in the literature in regard to treatment of isolated meniscal tear without concomitant ligamentous injury.…”

Section: Discussionmentioning

confidence: 99%

“…With regard to the timing of return-to-play (RTP), previous investigations have demonstrated that athletes typically RTP 1 to 3 months after meniscectomy 1 , 14 , 23 and 4 to 6 months after meniscal repair. 2 , 22 However, only 2 of these aforementioned studies have specifically isolated elite soccer players in their analyses.…”

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confidence: 99%

Return to Play and Player Performance After Meniscal Tear Among Elite-Level European Soccer Players: A Matched Cohort Analysis of Injuries From 2006 to 2016

Lavoie-Gagne

Korrapati

Retzky

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Meniscal injuries are extremely common in soccer athletes, and little is known about postrecovery performance. Purpose: To (1) identify characteristics associated with return to play (RTP) to the same league level and (2) evaluate long-term effects that injury and management approach may have on player performance. Study Design: Cohort study; Level of evidence, 3. Methods: Using publicly available records, we identified athletes who sustained meniscal tears across the 5 major European soccer leagues (English Premier League, Bundesliga, La Liga, Ligue 1, and Serie A) between 2006 and 2016. Injured athletes were matched to controls 1:2 by demographics and performance. Investigations included rate of RTP to the same league level, reinjury, player characteristics associated with RTP within 2 seasons, long-term availability, field time, and performance metrics standardized to 90 minutes of play during the next 4 seasons. Results: A total of 250 players sustaining meniscal tears were included, of which 106 (42%) received surgical management. Median absence was 57.5 days (interquartile range [IQR], 35-92) or 7 games (IQR, 4-12). Rate of RTP was 70%, and the reinjury rate 5% if a player could RTP. Age greater than 30 years was a negative predictor for RTP (odds ratio [OR], 0.62; P = .002), whereas higher preinjury goals per game (OR, 2.80; P = .04) and surgical management (OR, 1.38; P = .002) were positive predictors for RTP. Surgical management was associated with higher long-term availability ( P < .01). As compared with the control, there were no significant differences in field time or performance metrics after RTP, either overall or by player position. As compared with nonoperative management, defenders undergoing surgery demonstrated decreased field time. Attackers and midfielders demonstrated similar field time and performance regardless of management. Conclusion: RTP of elite soccer athletes sustaining meniscal tear is contingent on age, preinjury performance, and management approach. Those who RTP to the same league level can be expected to demonstrate equivalent field time, performance, and long-term availability as noninjured athletes.

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Three‐dimensional bone morphology is a risk factor for medial postmeniscectomy syndrome: A retrospective cohort study

Grammens,

Van Haver,

Danckaers

et al. 2024

J. exp. orthop.

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PurposeThe study aims to identify differences in tibiofemoral joint morphology between responders (R group, no pain) to arthroscopic partial medial meniscectomy (APMM) versus medial postmeniscectomy syndrome patients (MPMS group, recurrent pain at 2 years postmeniscectomy) in a clinically neutrally aligned patient population. The second aim was to build a morphology‐based predictive algorithm for response to treatment (RTT) in APMM.MethodsTwo patient groups were identified from a large multicentre database of meniscectomy patients at 2 years of follow‐up: the R group included 120 patients with a KOOS pain score > 75, and the MPMS group included 120 patients with a KOOS pain score ≤ 75. Statistical shape models (SSMs) of distal femur, proximal tibia and tibiofemoral joint were used to compare knee morphology. Finally, a predictive model was developed to predict RTT, with the SSM‐derived morphologic variables as predictors.ResultsNo differences were found between the R and MPMS groups for patient age, sex, height, weight or cartilage status. Knees in the MPMS group were significantly smaller, had a wider femoral notch and a smaller medial femoral condyle. A morphology‐based predictive model was able to predict MPMS at 2 years follow‐up with a sensitivity of 74.9% (95% confidence interval [CI]: 74.4%–75.4%) and a specificity of 81.0% (95% CI: 80.6%–81.5%).ConclusionA smaller tibiofemoral joint, a wider intercondylar notch and smaller medial femoral condyle were observed shape variations related to medial postmeniscectomy syndrome. These promising results are a first step towards a knee morphology‐based clinical decision support tool for meniscus treatment.Study DesignCase–control study.Level of EvidenceLevel IIIb.

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Predictive Factors and Duration to Return to Sport After Isolated Meniscectomy

Cited by 18 publications

References 42 publications

Predictive Factors Associated With Short-Term Clinical Outcomes and Time to Return to Activity After Arthroscopic Partial Meniscectomy in Nonathletes

Predictive Factors Associated With Short-Term Clinical Outcomes and Time to Return to Activity After Arthroscopic Partial Meniscectomy in Nonathletes

Return to Play and Player Performance After Meniscal Tear Among Elite-Level European Soccer Players: A Matched Cohort Analysis of Injuries From 2006 to 2016

Three‐dimensional bone morphology is a risk factor for medial postmeniscectomy syndrome: A retrospective cohort study

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