Less improvement following meniscal repair compared with arthroscopic partial meniscectomy: a prospective cohort study of patient-reported outcomes in 150 young adults at 1- and 5-years’ follow-up

Kenneth Pihl, Martin Englund, Robin Christensen, L. Stefan Lohmander, Uffe Jørgensen, Bjarke Viberg, Jakob Vium Fristed, Jonas B. Thorlund*

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Abstrakt

Background and purpose — Meniscal repair may reduce long-term risk of knee osteoarthritis compared with arthroscopic partial meniscectomy (APM), whereas patient-reported outcomes may be poorer at short term than for APM. We compared patient-reported outcomes in young adults undergoing meniscal repair or APM up to ∼5 years after surgery. Patients and methods — We included 150 patients aged 18–40 years from the Knee Arthroscopy Cohort Southern Denmark (KACS) undergoing meniscal repair or APM. Between-group differences in change in a composite of 4 of 5 Knee injury and Osteoarthritis Outcome Score (KOOS) subscales (pain, symptoms, sport and recreation, and quality of life—KOOS4) from baseline, 12, and 52 weeks, and a median of 5 years (range 4–6 years) were analyzed using adjusted mixed linear models, with 52 weeks being the primary endpoint. Results — 32 patients had meniscal repair (mean age 26 [SD 6]), and 118 patients underwent APM (mean age 32 [SD 7]). The repair and APM groups improved in KOOS4 from before to 52 weeks after surgery (least square means 7 and 19, respectively; adjusted mean difference –12, [95% CI –19 to –4] in favor of APM). Both groups improved further from 52 weeks to 5 years after surgery with the difference in KOOS4 scores between the groups remaining similar. Interpretation — Patients having meniscal repair experienced less improvements in patient-reported outcomes from baseline to 52 weeks and 5 years post-surgery. The findings highlight the need for randomized trials comparing these interventions in terms of patient-reported outcomes and knee OA development.

OriginalsprogEngelsk
TidsskriftActa Orthopaedica
Vol/bind92
Udgave nummer5
Sider (fra-til)589-596
ISSN1745-3674
DOI
StatusUdgivet - okt. 2021

Bibliografisk note

Funding Information:
This study was supported by an individual postdoctoral grant (JBT) from the Danish Council for Independent Research/Medical Sciences and funds from the Region of Southern Denmark. RC acknowledge that the Parker Institute, Bispebjerg and Frederiksberg Hospital is supported by a core grant from the Oak Foundation (OCAY-18-774-OFIL).

Funding Information:
BV reports personal fees from Osmedic Swemac and Zimmer Biomet outside the submitted work. JBT reports grants from Pfizer outside the submitted work. ME reports personal fees from Pfizer outside the submitted work. RC reports honorarium to employer from (1) Lectures: Research Methods (Pfizer, DK; 2017); GRADE Lecture (Celgene, DK; 2017), Ad Board Lecture: CAM (Orkla Health, DK; 2017); Diet in RMD (Novartis, DK; 2019); Ad Board Lecture: GRADE (Lilly, DK; 2017); Network MAs (LEO; 2020) and ((Mundipharma, 2019) and (3) Consultancy Reports: Network MAs (Biogen, DK; 2017), other from); GRADE (Celgene, 2018) all outside the submitted work. The remaining authors have nothing to declare.

Publisher Copyright:
© 2021 The Author(s). Published by Taylor & Francis on behalf of the Nordic Orthopedic Federation.

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