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Less improvement following meniscal repair compared with arthroscopic partial meniscectomy : a prospective cohort study of patient-reported outcomes in 150 young adults at 1- and 5-years’ follow-up

Pihl, Kenneth LU orcid ; Englund, Martin LU orcid ; Christensen, Robin ; Lohmander, L. Stefan LU orcid ; Jørgensen, Uffe ; Viberg, Bjarke ; Fristed, Jakob Vium and Thorlund, Jonas B. (2021) In Acta Orthopaedica 92(5). p.589-596
Abstract

Background and purpose — Meniscal repair may reduce long-term risk of knee osteoarthritis compared with arthroscopic partial meniscectomy (APM), whereas patient-reported outcomes may be poorer at short term than for APM. We compared patient-reported outcomes in young adults undergoing meniscal repair or APM up to ∼5 years after surgery. Patients and methods — We included 150 patients aged 18–40 years from the Knee Arthroscopy Cohort Southern Denmark (KACS) undergoing meniscal repair or APM. Between-group differences in change in a composite of 4 of 5 Knee injury and Osteoarthritis Outcome Score (KOOS) subscales (pain, symptoms, sport and recreation, and quality of life—KOOS4) from baseline, 12, and 52 weeks, and a median of 5... (More)

Background and purpose — Meniscal repair may reduce long-term risk of knee osteoarthritis compared with arthroscopic partial meniscectomy (APM), whereas patient-reported outcomes may be poorer at short term than for APM. We compared patient-reported outcomes in young adults undergoing meniscal repair or APM up to ∼5 years after surgery. Patients and methods — We included 150 patients aged 18–40 years from the Knee Arthroscopy Cohort Southern Denmark (KACS) undergoing meniscal repair or APM. Between-group differences in change in a composite of 4 of 5 Knee injury and Osteoarthritis Outcome Score (KOOS) subscales (pain, symptoms, sport and recreation, and quality of life—KOOS4) from baseline, 12, and 52 weeks, and a median of 5 years (range 4–6 years) were analyzed using adjusted mixed linear models, with 52 weeks being the primary endpoint. Results — 32 patients had meniscal repair (mean age 26 [SD 6]), and 118 patients underwent APM (mean age 32 [SD 7]). The repair and APM groups improved in KOOS4 from before to 52 weeks after surgery (least square means 7 and 19, respectively; adjusted mean difference –12, [95% CI –19 to –4] in favor of APM). Both groups improved further from 52 weeks to 5 years after surgery with the difference in KOOS4 scores between the groups remaining similar. Interpretation — Patients having meniscal repair experienced less improvements in patient-reported outcomes from baseline to 52 weeks and 5 years post-surgery. The findings highlight the need for randomized trials comparing these interventions in terms of patient-reported outcomes and knee OA development.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Orthopaedica
volume
92
issue
5
pages
589 - 596
publisher
Taylor & Francis
external identifiers
  • pmid:33929284
  • scopus:85105237254
ISSN
1745-3674
DOI
10.1080/17453674.2021.1917826
language
English
LU publication?
yes
id
6ac8f5b7-7e75-4ffa-9fda-d90c0e5a7012
date added to LUP
2021-05-28 16:51:12
date last changed
2025-03-09 13:25:34
@article{6ac8f5b7-7e75-4ffa-9fda-d90c0e5a7012,
  abstract     = {{<p>Background and purpose — Meniscal repair may reduce long-term risk of knee osteoarthritis compared with arthroscopic partial meniscectomy (APM), whereas patient-reported outcomes may be poorer at short term than for APM. We compared patient-reported outcomes in young adults undergoing meniscal repair or APM up to ∼5 years after surgery. Patients and methods — We included 150 patients aged 18–40 years from the Knee Arthroscopy Cohort Southern Denmark (KACS) undergoing meniscal repair or APM. Between-group differences in change in a composite of 4 of 5 Knee injury and Osteoarthritis Outcome Score (KOOS) subscales (pain, symptoms, sport and recreation, and quality of life—KOOS<sub>4</sub>) from baseline, 12, and 52 weeks, and a median of 5 years (range 4–6 years) were analyzed using adjusted mixed linear models, with 52 weeks being the primary endpoint. Results — 32 patients had meniscal repair (mean age 26 [SD 6]), and 118 patients underwent APM (mean age 32 [SD 7]). The repair and APM groups improved in KOOS<sub>4</sub> from before to 52 weeks after surgery (least square means 7 and 19, respectively; adjusted mean difference –12, [95% CI –19 to –4] in favor of APM). Both groups improved further from 52 weeks to 5 years after surgery with the difference in KOOS<sub>4</sub> scores between the groups remaining similar. Interpretation — Patients having meniscal repair experienced less improvements in patient-reported outcomes from baseline to 52 weeks and 5 years post-surgery. The findings highlight the need for randomized trials comparing these interventions in terms of patient-reported outcomes and knee OA development.</p>}},
  author       = {{Pihl, Kenneth and Englund, Martin and Christensen, Robin and Lohmander, L. Stefan and Jørgensen, Uffe and Viberg, Bjarke and Fristed, Jakob Vium and Thorlund, Jonas B.}},
  issn         = {{1745-3674}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{589--596}},
  publisher    = {{Taylor & Francis}},
  series       = {{Acta Orthopaedica}},
  title        = {{Less improvement following meniscal repair compared with arthroscopic partial meniscectomy : a prospective cohort study of patient-reported outcomes in 150 young adults at 1- and 5-years’ follow-up}},
  url          = {{http://dx.doi.org/10.1080/17453674.2021.1917826}},
  doi          = {{10.1080/17453674.2021.1917826}},
  volume       = {{92}},
  year         = {{2021}},
}