Structural pathology is not related to patient-reported pain and function in patients undergoing meniscal surgery. Issue 6 (16th September 2016)

• Record Type: Journal Article
• Authors: Tornbjerg, Simon Maretti; Nissen, Nis; Englund, Martin; Jørgensen, Uffe; Schjerning, Jeppe; Lohmander, L Stefan; Thorlund, Jonas Bloch
• Is Part Of: British journal of sports medicine. Volume 51:Issue 6(2017)
• Page Start: 525
• Page End: 530
• Publication Date: 2016-09-16
• Subjects: Knee -- Meniscus -- Arthroscopy -- Surgery; Sports medicine -- Periodicals; 617.1027
• DOI: 10.1136/bjsports-2016-096456
• Languages: English
• ISSNs: 0306-3674

Abstract

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 R 2 =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.