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Change in patient-reported outcomes in patients with and without mechanical symptoms undergoing arthroscopic meniscal surgery : A prospective cohort study

Pihl, K.; Turkiewicz, A. LU ; Englund, M. LU ; Lohmander, L. S. LU ; Jørgensen, U.; Nissen, N.; Schjerning, J. and Thorlund, J. B. (2018) In Osteoarthritis and Cartilage 26(8). p.1008-1016
Abstract

Objective: Patients with degenerative or traumatic meniscal tears are at high risk of developing knee osteoarthritis. We investigated if younger (≤40 years) and older (>40 years) patients with preoperative mechanical symptoms (MS) improved more in patient-reported outcomes after meniscal surgery than those without MS. Design: Patients from Knee Arthroscopy Cohort Southern Denmark (KACS) undergoing arthroscopic surgery for a meniscal tear completed online questionnaires before surgery, and at 12 and 52 weeks follow-up. Questionnaires included self-reported presence of MS (i.e., sensation of catching and/or locking) and the Knee injury and Osteoarthritis Outcome Score (KOOS). We analyzed between-group differences in change in... (More)

Objective: Patients with degenerative or traumatic meniscal tears are at high risk of developing knee osteoarthritis. We investigated if younger (≤40 years) and older (>40 years) patients with preoperative mechanical symptoms (MS) improved more in patient-reported outcomes after meniscal surgery than those without MS. Design: Patients from Knee Arthroscopy Cohort Southern Denmark (KACS) undergoing arthroscopic surgery for a meniscal tear completed online questionnaires before surgery, and at 12 and 52 weeks follow-up. Questionnaires included self-reported presence of MS (i.e., sensation of catching and/or locking) and the Knee injury and Osteoarthritis Outcome Score (KOOS). We analyzed between-group differences in change in KOOS4 from baseline to 52 weeks, using an adjusted mixed linear model. Results: 150 younger patients (mean age 31 (SD 7), 67% men) and 491 older patients (mean age 54 (SD 9), 53% men) constituted the baseline cohorts. Patients with MS generally had worse self-reported outcomes before surgery. At 52 weeks follow-up, younger patients with preoperative MS had improved more in KOOS4 scores than younger patients without preoperative MS (adjusted mean difference 10.5, 95% CI: 4.3, 16.6), but did not exceed the absolute postoperative KOOS4 scores observed for those without MS. No difference in improvement was observed between older patients with or without MS (adjusted mean difference 0.7, 95% CI: −2.6, 3.9). Conclusions: Younger patients (≤40 years) with preoperative MS experienced greater improvements after arthroscopic surgery compared to younger patients without MS. Our observational study result needs to be confirmed in randomized trials.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Arthroscopy, Knee, Mechanical symptoms, Meniscal tears, Osteoarthritis, Patient-reported outcomes
in
Osteoarthritis and Cartilage
volume
26
issue
8
pages
1008 - 1016
publisher
Elsevier
external identifiers
  • scopus:85047920348
ISSN
1063-4584
DOI
10.1016/j.joca.2018.05.004
language
English
LU publication?
yes
id
c5ed226f-fe5a-4572-87c4-cf6e34bf5397
date added to LUP
2018-06-15 13:25:39
date last changed
2019-02-20 11:20:07
@article{c5ed226f-fe5a-4572-87c4-cf6e34bf5397,
  abstract     = {<p>Objective: Patients with degenerative or traumatic meniscal tears are at high risk of developing knee osteoarthritis. We investigated if younger (≤40 years) and older (&gt;40 years) patients with preoperative mechanical symptoms (MS) improved more in patient-reported outcomes after meniscal surgery than those without MS. Design: Patients from Knee Arthroscopy Cohort Southern Denmark (KACS) undergoing arthroscopic surgery for a meniscal tear completed online questionnaires before surgery, and at 12 and 52 weeks follow-up. Questionnaires included self-reported presence of MS (i.e., sensation of catching and/or locking) and the Knee injury and Osteoarthritis Outcome Score (KOOS). We analyzed between-group differences in change in KOOS<sub>4</sub> from baseline to 52 weeks, using an adjusted mixed linear model. Results: 150 younger patients (mean age 31 (SD 7), 67% men) and 491 older patients (mean age 54 (SD 9), 53% men) constituted the baseline cohorts. Patients with MS generally had worse self-reported outcomes before surgery. At 52 weeks follow-up, younger patients with preoperative MS had improved more in KOOS<sub>4</sub> scores than younger patients without preoperative MS (adjusted mean difference 10.5, 95% CI: 4.3, 16.6), but did not exceed the absolute postoperative KOOS<sub>4</sub> scores observed for those without MS. No difference in improvement was observed between older patients with or without MS (adjusted mean difference 0.7, 95% CI: −2.6, 3.9). Conclusions: Younger patients (≤40 years) with preoperative MS experienced greater improvements after arthroscopic surgery compared to younger patients without MS. Our observational study result needs to be confirmed in randomized trials.</p>},
  author       = {Pihl, K. and Turkiewicz, A. and Englund, M. and Lohmander, L. S. and Jørgensen, U. and Nissen, N. and Schjerning, J. and Thorlund, J. B.},
  issn         = {1063-4584},
  keyword      = {Arthroscopy,Knee,Mechanical symptoms,Meniscal tears,Osteoarthritis,Patient-reported outcomes},
  language     = {eng},
  number       = {8},
  pages        = {1008--1016},
  publisher    = {Elsevier},
  series       = {Osteoarthritis and Cartilage},
  title        = {Change in patient-reported outcomes in patients with and without mechanical symptoms undergoing arthroscopic meniscal surgery : A prospective cohort study},
  url          = {http://dx.doi.org/10.1016/j.joca.2018.05.004},
  volume       = {26},
  year         = {2018},
}