Advanced

Structural pathology is not related to patientreported pain and function in patients undergoing meniscal surgery

Tornbjerg, Simon Maretti; Nissen, Nis; Englund, Martin LU ; Jørgensen, Uffe; Schjerning, Jeppe; Lohmander, L. Stefan LU and Thorlund, Jonas Bloch (2017) In British Journal of Sports Medicine 51. p.525-530
Abstract

Background The relationship between meniscal tears and other joint pathologies with patient-reported symptoms is not clear. We investigated associations between structural knee pathologies identified at surgery with preoperative knee pain and function in patients undergoing arthroscopic meniscal surgery. Methods This study included 443 patients from the Knee Arthroscopy Cohort Southern Denmark (KACS), a prospective cohort following patients 18 years or older undergoing arthroscopic meniscal surgery at 4 hospitals between 1 February 2013 and 31 January 2014. Patient-reported outcomes, including the Knee Injury and Osteoarthritis Outcome Score (KOOS), were obtained by online questionnaires prior to surgery. Knee pathology was assessed by... (More)

Background The relationship between meniscal tears and other joint pathologies with patient-reported symptoms is not clear. We investigated associations between structural knee pathologies identified at surgery with preoperative knee pain and function in patients undergoing arthroscopic meniscal surgery. Methods This study included 443 patients from the Knee Arthroscopy Cohort Southern Denmark (KACS), a prospective cohort following patients 18 years or older undergoing arthroscopic meniscal surgery at 4 hospitals between 1 February 2013 and 31 January 2014. Patient-reported outcomes, including the Knee Injury and Osteoarthritis Outcome Score (KOOS), were obtained by online questionnaires prior to surgery. Knee pathology was assessed by the operating surgeons using a modified version of the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) classification of meniscal tears questionnaire, supplemented with information extracted from surgery reports. Following hypothesis-driven preselection of candidate variables, backward elimination regressions were performed to investigate associations between patient-reported outcomes and structural knee pathologies. Results Regression models only explained a small proportion of the variability in self-reported pain and function (adjusted R2=0.10-0.12) and this association was mainly driven by age, gender and body mass index. Conclusions Specific meniscal pathology and other structural joint pathologies found at meniscal surgery were not associated with preoperative self-reported pain and function in patients with meniscal tears questioning inferences made about a direct relationship between these. Our findings question the role of arthroscopic surgery to address structural pathology as a means to improve patient-reported outcomes in patients having surgery for a meniscal tear.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
British Journal of Sports Medicine
volume
51
pages
525 - 530
publisher
BMJ Publishing Group
external identifiers
  • scopus:84988481804
  • wos:000394542700013
ISSN
0306-3674
DOI
10.1136/bjsports-2016-096456
language
English
LU publication?
yes
id
8e01b9eb-7250-4914-83a6-22962fd1cea5
date added to LUP
2016-10-28 16:03:49
date last changed
2018-01-07 11:32:40
@article{8e01b9eb-7250-4914-83a6-22962fd1cea5,
  abstract     = {<p>Background The relationship between meniscal tears and other joint pathologies with patient-reported symptoms is not clear. We investigated associations between structural knee pathologies identified at surgery with preoperative knee pain and function in patients undergoing arthroscopic meniscal surgery. Methods This study included 443 patients from the Knee Arthroscopy Cohort Southern Denmark (KACS), a prospective cohort following patients 18 years or older undergoing arthroscopic meniscal surgery at 4 hospitals between 1 February 2013 and 31 January 2014. Patient-reported outcomes, including the Knee Injury and Osteoarthritis Outcome Score (KOOS), were obtained by online questionnaires prior to surgery. Knee pathology was assessed by the operating surgeons using a modified version of the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) classification of meniscal tears questionnaire, supplemented with information extracted from surgery reports. Following hypothesis-driven preselection of candidate variables, backward elimination regressions were performed to investigate associations between patient-reported outcomes and structural knee pathologies. Results Regression models only explained a small proportion of the variability in self-reported pain and function (adjusted R<sup>2</sup>=0.10-0.12) and this association was mainly driven by age, gender and body mass index. Conclusions Specific meniscal pathology and other structural joint pathologies found at meniscal surgery were not associated with preoperative self-reported pain and function in patients with meniscal tears questioning inferences made about a direct relationship between these. Our findings question the role of arthroscopic surgery to address structural pathology as a means to improve patient-reported outcomes in patients having surgery for a meniscal tear.</p>},
  author       = {Tornbjerg, Simon Maretti and Nissen, Nis and Englund, Martin and Jørgensen, Uffe and Schjerning, Jeppe and Lohmander, L. Stefan and Thorlund, Jonas Bloch},
  issn         = {0306-3674},
  language     = {eng},
  pages        = {525--530},
  publisher    = {BMJ Publishing Group},
  series       = {British Journal of Sports Medicine},
  title        = {Structural pathology is not related to patientreported pain and function in patients undergoing meniscal surgery},
  url          = {http://dx.doi.org/10.1136/bjsports-2016-096456},
  volume       = {51},
  year         = {2017},
}