Simon Maretti Tornbjerg1,2, Nis Nissen2, Martin Englund3,4, Uffe Jørgensen5, Jeppe Schjerning6, L Stefan Lohmander7, Jonas Bloch Thorlund1. 1. Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark. 2. Department of Orthopaedics, Lillebaelt Hospital, Kolding, Denmark. 3. Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden. 4. Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Massachusetts, USA. 5. Department of Orthopaedics and Traumatology, Odense University Hospital, Odense, Denmark. 6. Department of Orthopaedics, Lillebaelt Hospital, Vejle, Denmark. 7. Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Lund University, Lund, Sweden.
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 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Authors: R Seil; Jon Karlsson; P Beaufils; R Becker; S Kopf; M Ollivier; M Denti Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-02 Impact factor: 4.342
Authors: Leander L S Muheim; Oliver Senn; Mathias Früh; Oliver Reich; Thomas Rosemann; Stefan M Neuner-Jehle Journal: Acta Orthop Date: 2017-06-30 Impact factor: 3.717
Authors: Ph Beaufils; R Becker; S Kopf; M Englund; R Verdonk; M Ollivier; R Seil Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-02-16 Impact factor: 4.342
Authors: Raine Sihvonen; Mika Paavola; Antti Malmivaara; Ari Itälä; Antti Joukainen; Heikki Nurmi; Juha Kalske; Anna Ikonen; Timo Järvelä; Tero A H Järvinen; Kari Kanto; Janne Karhunen; Jani Knifsund; Heikki Kröger; Tommi Kääriäinen; Janne Lehtinen; Jukka Nyrhinen; Juha Paloneva; Outi Päiväniemi; Marko Raivio; Janne Sahlman; Roope Sarvilinna; Sikri Tukiainen; Ville-Valtteri Välimäki; Ville Äärimaa; Pirjo Toivonen; Teppo L N Järvinen Journal: Ann Rheum Dis Date: 2017-05-18 Impact factor: 19.103
Authors: Tom Arild Torstensen; Wilhelmus J A Grooten; Håvard Østerås; Annette Heijne; Karin Harms-Ringdahl; Björn Olov Äng Journal: BMJ Open Date: 2018-05-05 Impact factor: 2.692
Authors: Robin Holtedahl; Jens Ivar Brox; Arne Kristian Aune; Daniel Nguyen; May Arna Risberg; Ole Tjomsland Journal: BMJ Open Date: 2018-06-15 Impact factor: 2.692