Two-year MRI-defined structural damage and patient-reported outcomes following surgery or exercise for meniscal tears in young adults
(2023) In British journal of sports medicine 57(24).- Abstract
Objective: To investigate potential differences in structural knee joint damage assessed by MRI and patient-reported outcomes (PROMs) at 2-year follow-up between young adults randomised to early surgery or exercise and education with optional delayed surgery for a meniscal tear. Methods: A secondary analysis of a multicentre randomised controlled trial including 121 patients (18-40 years) with an MRI-verified meniscal tear. For this study, only patients with 2-year follow-up were included. The main outcomes were the difference in worsening of structural knee damage, assessed by MRI using the Anterior Cruciate Ligament OsteoArthrits Score, and the difference in change in the mean score of four Knee Injury and Osteoarthritis Outcome Score... (More)
Objective: To investigate potential differences in structural knee joint damage assessed by MRI and patient-reported outcomes (PROMs) at 2-year follow-up between young adults randomised to early surgery or exercise and education with optional delayed surgery for a meniscal tear. Methods: A secondary analysis of a multicentre randomised controlled trial including 121 patients (18-40 years) with an MRI-verified meniscal tear. For this study, only patients with 2-year follow-up were included. The main outcomes were the difference in worsening of structural knee damage, assessed by MRI using the Anterior Cruciate Ligament OsteoArthrits Score, and the difference in change in the mean score of four Knee Injury and Osteoarthritis Outcome Score (KOOS4) subscales covering pain, symptoms, function in sport and recreation, and quality of life, from baseline to 2 years. Results: In total, 82/121 (68%) patients completed the 2-year follow-up (39 from the surgical group and 43 from the exercise group). MRI-defined cartilage damage had developed or progressed in seven (9.1%) patients and osteophytes developed in two (2.6%) patients. The worsening of structural damage from baseline to 2-year follow-up was similar between groups. The mean (95% CI) adjusted differences in change in KOOS4 between intervention groups from baseline to 2 years was -1.4 (-9.1, 6.2) points. The mean improvement in KOOS4 was 16.4 (10.4, 22.4) in the surgical group and 21.5 (15.0, 28.0) in the exercise group. No between group differences in improvement were found in the KOOS subscales. Conclusions: The 2-year worsening of MRI-defined structural damage was limited and similar in young adult patients with a meniscal tear treated with surgery or exercise with optional delayed surgery. Both groups had similar clinically relevant improvements in KOOS4, suggesting the choice of treatment strategy does not impact 2-year structural knee damage or PROMs. Trial registration number: NCT02995551.
(Less)
- author
- Clausen, Stine Haugaard
; Skou, Søren T.
; Boesen, Mikael Ploug
; Radev, Dimitar Ivanon
; Kurt, Engin Yeter
; Damsted, Camma
; Hölmich, Per
; Lind, Martin
; Tørring, Sofus
; Isaksen, Christin
; Varnum, Claus
; Englund, Martin
LU
and Thorlund, Jonas Bloch
(Less) - organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Arthroscopy, Exercise Therapy, Meniscus, Osteoarthritis
- in
- British journal of sports medicine
- volume
- 57
- issue
- 24
- article number
- bjsports-2023-107352
- publisher
- BMJ Publishing Group
- external identifiers
-
- pmid:37879858
- scopus:85175850914
- ISSN
- 0306-3674
- DOI
- 10.1136/bjsports-2023-107352
- language
- English
- LU publication?
- yes
- id
- 9f707502-25a1-49bd-8c06-5b547be37276
- date added to LUP
- 2023-12-06 13:11:39
- date last changed
- 2024-11-16 06:09:43
@article{9f707502-25a1-49bd-8c06-5b547be37276,
abstract = {{<p>Objective: To investigate potential differences in structural knee joint damage assessed by MRI and patient-reported outcomes (PROMs) at 2-year follow-up between young adults randomised to early surgery or exercise and education with optional delayed surgery for a meniscal tear. Methods: A secondary analysis of a multicentre randomised controlled trial including 121 patients (18-40 years) with an MRI-verified meniscal tear. For this study, only patients with 2-year follow-up were included. The main outcomes were the difference in worsening of structural knee damage, assessed by MRI using the Anterior Cruciate Ligament OsteoArthrits Score, and the difference in change in the mean score of four Knee Injury and Osteoarthritis Outcome Score (KOOS4) subscales covering pain, symptoms, function in sport and recreation, and quality of life, from baseline to 2 years. Results: In total, 82/121 (68%) patients completed the 2-year follow-up (39 from the surgical group and 43 from the exercise group). MRI-defined cartilage damage had developed or progressed in seven (9.1%) patients and osteophytes developed in two (2.6%) patients. The worsening of structural damage from baseline to 2-year follow-up was similar between groups. The mean (95% CI) adjusted differences in change in KOOS4 between intervention groups from baseline to 2 years was -1.4 (-9.1, 6.2) points. The mean improvement in KOOS4 was 16.4 (10.4, 22.4) in the surgical group and 21.5 (15.0, 28.0) in the exercise group. No between group differences in improvement were found in the KOOS subscales. Conclusions: The 2-year worsening of MRI-defined structural damage was limited and similar in young adult patients with a meniscal tear treated with surgery or exercise with optional delayed surgery. Both groups had similar clinically relevant improvements in KOOS4, suggesting the choice of treatment strategy does not impact 2-year structural knee damage or PROMs. Trial registration number: NCT02995551.</p>}},
author = {{Clausen, Stine Haugaard and Skou, Søren T. and Boesen, Mikael Ploug and Radev, Dimitar Ivanon and Kurt, Engin Yeter and Damsted, Camma and Hölmich, Per and Lind, Martin and Tørring, Sofus and Isaksen, Christin and Varnum, Claus and Englund, Martin and Thorlund, Jonas Bloch}},
issn = {{0306-3674}},
keywords = {{Arthroscopy; Exercise Therapy; Meniscus; Osteoarthritis}},
language = {{eng}},
number = {{24}},
publisher = {{BMJ Publishing Group}},
series = {{British journal of sports medicine}},
title = {{Two-year MRI-defined structural damage and patient-reported outcomes following surgery or exercise for meniscal tears in young adults}},
url = {{http://dx.doi.org/10.1136/bjsports-2023-107352}},
doi = {{10.1136/bjsports-2023-107352}},
volume = {{57}},
year = {{2023}},
}