Association of specific meniscal pathologies and other structural pathologies with self-reported mechanical symptoms: A cross-sectional study of 566 patients undergoing meniscal surgery

Kenneth Pihl*, Aleksandra Turkiewicz, Martin Englund, L. Stefan Lohmander, Uffe Jørgensen, Nis Nissen, Jeppe Schjerning, Jonas B. Thorlund

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Objectives: We explored associations between specific meniscal pathologies and other concurrent structural knee pathologies with presence of self-reported mechanical symptoms in patients undergoing meniscal surgery. Design: Cross-sectional study. Methods: We included patients undergoing surgery for a meniscal tear from Knee Arthroscopy Cohort Southern Denmark (KACS). Pre-surgery, patients completed online questionnaires including self-reported presence of mechanical symptoms. At arthroscopy, surgeons recorded information about specific meniscal pathologies and other concurrent structural knee pathologies. Relative risks (RR) were estimated to assess associations between specific meniscal pathologies and other structural knee pathologies with preoperative mechanical symptoms from multivariable logistic regression. Results: 566 of 641 patients (mean age 48.6[SD 12.9] years, 57% men) with complete data were included. 386 (68%) patients reported mechanical symptoms of knee catching/locking and/or extension deficit. Most evaluated joint pathologies were not associated with mechanical symptoms of any kind with RRs close to 1.0. Meniscal tears involving both the posterior and anterior horn (n = 22) were associated with knee catching/locking (RR: 1.49[95%CI:1.15–1.93]), and a tear in both menisci (n = 49) was associated with extension deficit of the knee (RR: 1.32[95%CI:1.01–1.73]). A partial (n = 29) and total ACL rupture (n = 37) were each associated with extension deficit (RR: 1.83[95%CI:1.47–2.28] and RR: 1.44[95%CI:1.05–1.98], respectively). Conclusions: Limited associations between specific meniscal pathology and other concurrent knee joint pathologies with presence of self-reported mechanical symptoms were found in patients undergoing meniscal surgery. The findings question the clinical importance of mechanical symptoms as an indicator for arthroscopy for specific meniscal tears with the specific aim to relieve such symptoms.

Original languageEnglish
JournalJournal of Science and Medicine in Sport
Volume22
Issue number2
Pages (from-to)151-157
ISSN1440-2440
DOIs
Publication statusPublished - Feb 2019

Fingerprint

Cross-Sectional Studies
Pathology
Knee
Denmark
Knee Joint
Rupture
Joints
Logistic Models

Keywords

  • Arthroscopy
  • Knee joint
  • Mechanical symptoms
  • Meniscus
  • Osteoarthritis
  • Tibial meniscus injuries

Cite this

@article{e074102898a04d2caa6c3c97373db64e,
title = "Association of specific meniscal pathologies and other structural pathologies with self-reported mechanical symptoms: A cross-sectional study of 566 patients undergoing meniscal surgery",
abstract = "Objectives: We explored associations between specific meniscal pathologies and other concurrent structural knee pathologies with presence of self-reported mechanical symptoms in patients undergoing meniscal surgery. Design: Cross-sectional study. Methods: We included patients undergoing surgery for a meniscal tear from Knee Arthroscopy Cohort Southern Denmark (KACS). Pre-surgery, patients completed online questionnaires including self-reported presence of mechanical symptoms. At arthroscopy, surgeons recorded information about specific meniscal pathologies and other concurrent structural knee pathologies. Relative risks (RR) were estimated to assess associations between specific meniscal pathologies and other structural knee pathologies with preoperative mechanical symptoms from multivariable logistic regression. Results: 566 of 641 patients (mean age 48.6[SD 12.9] years, 57{\%} men) with complete data were included. 386 (68{\%}) patients reported mechanical symptoms of knee catching/locking and/or extension deficit. Most evaluated joint pathologies were not associated with mechanical symptoms of any kind with RRs close to 1.0. Meniscal tears involving both the posterior and anterior horn (n = 22) were associated with knee catching/locking (RR: 1.49[95{\%}CI:1.15–1.93]), and a tear in both menisci (n = 49) was associated with extension deficit of the knee (RR: 1.32[95{\%}CI:1.01–1.73]). A partial (n = 29) and total ACL rupture (n = 37) were each associated with extension deficit (RR: 1.83[95{\%}CI:1.47–2.28] and RR: 1.44[95{\%}CI:1.05–1.98], respectively). Conclusions: Limited associations between specific meniscal pathology and other concurrent knee joint pathologies with presence of self-reported mechanical symptoms were found in patients undergoing meniscal surgery. The findings question the clinical importance of mechanical symptoms as an indicator for arthroscopy for specific meniscal tears with the specific aim to relieve such symptoms.",
keywords = "Arthroscopy, Knee joint, Mechanical symptoms, Meniscus, Osteoarthritis, Tibial meniscus injuries",
author = "Kenneth Pihl and Aleksandra Turkiewicz and Martin Englund and Lohmander, {L. Stefan} and Uffe J{\o}rgensen and Nis Nissen and Jeppe Schjerning and Thorlund, {Jonas B.}",
year = "2019",
month = "2",
doi = "10.1016/j.jsams.2018.07.018",
language = "English",
volume = "22",
pages = "151--157",
journal = "Journal of Science and Medicine in Sport",
issn = "1440-2440",
publisher = "Elsevier",
number = "2",

}

Association of specific meniscal pathologies and other structural pathologies with self-reported mechanical symptoms : A cross-sectional study of 566 patients undergoing meniscal surgery. / Pihl, Kenneth; Turkiewicz, Aleksandra; Englund, Martin; Lohmander, L. Stefan; Jørgensen, Uffe; Nissen, Nis; Schjerning, Jeppe; Thorlund, Jonas B.

In: Journal of Science and Medicine in Sport, Vol. 22, No. 2, 02.2019, p. 151-157.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Association of specific meniscal pathologies and other structural pathologies with self-reported mechanical symptoms

T2 - A cross-sectional study of 566 patients undergoing meniscal surgery

AU - Pihl, Kenneth

AU - Turkiewicz, Aleksandra

AU - Englund, Martin

AU - Lohmander, L. Stefan

AU - Jørgensen, Uffe

AU - Nissen, Nis

AU - Schjerning, Jeppe

AU - Thorlund, Jonas B.

PY - 2019/2

Y1 - 2019/2

N2 - Objectives: We explored associations between specific meniscal pathologies and other concurrent structural knee pathologies with presence of self-reported mechanical symptoms in patients undergoing meniscal surgery. Design: Cross-sectional study. Methods: We included patients undergoing surgery for a meniscal tear from Knee Arthroscopy Cohort Southern Denmark (KACS). Pre-surgery, patients completed online questionnaires including self-reported presence of mechanical symptoms. At arthroscopy, surgeons recorded information about specific meniscal pathologies and other concurrent structural knee pathologies. Relative risks (RR) were estimated to assess associations between specific meniscal pathologies and other structural knee pathologies with preoperative mechanical symptoms from multivariable logistic regression. Results: 566 of 641 patients (mean age 48.6[SD 12.9] years, 57% men) with complete data were included. 386 (68%) patients reported mechanical symptoms of knee catching/locking and/or extension deficit. Most evaluated joint pathologies were not associated with mechanical symptoms of any kind with RRs close to 1.0. Meniscal tears involving both the posterior and anterior horn (n = 22) were associated with knee catching/locking (RR: 1.49[95%CI:1.15–1.93]), and a tear in both menisci (n = 49) was associated with extension deficit of the knee (RR: 1.32[95%CI:1.01–1.73]). A partial (n = 29) and total ACL rupture (n = 37) were each associated with extension deficit (RR: 1.83[95%CI:1.47–2.28] and RR: 1.44[95%CI:1.05–1.98], respectively). Conclusions: Limited associations between specific meniscal pathology and other concurrent knee joint pathologies with presence of self-reported mechanical symptoms were found in patients undergoing meniscal surgery. The findings question the clinical importance of mechanical symptoms as an indicator for arthroscopy for specific meniscal tears with the specific aim to relieve such symptoms.

AB - Objectives: We explored associations between specific meniscal pathologies and other concurrent structural knee pathologies with presence of self-reported mechanical symptoms in patients undergoing meniscal surgery. Design: Cross-sectional study. Methods: We included patients undergoing surgery for a meniscal tear from Knee Arthroscopy Cohort Southern Denmark (KACS). Pre-surgery, patients completed online questionnaires including self-reported presence of mechanical symptoms. At arthroscopy, surgeons recorded information about specific meniscal pathologies and other concurrent structural knee pathologies. Relative risks (RR) were estimated to assess associations between specific meniscal pathologies and other structural knee pathologies with preoperative mechanical symptoms from multivariable logistic regression. Results: 566 of 641 patients (mean age 48.6[SD 12.9] years, 57% men) with complete data were included. 386 (68%) patients reported mechanical symptoms of knee catching/locking and/or extension deficit. Most evaluated joint pathologies were not associated with mechanical symptoms of any kind with RRs close to 1.0. Meniscal tears involving both the posterior and anterior horn (n = 22) were associated with knee catching/locking (RR: 1.49[95%CI:1.15–1.93]), and a tear in both menisci (n = 49) was associated with extension deficit of the knee (RR: 1.32[95%CI:1.01–1.73]). A partial (n = 29) and total ACL rupture (n = 37) were each associated with extension deficit (RR: 1.83[95%CI:1.47–2.28] and RR: 1.44[95%CI:1.05–1.98], respectively). Conclusions: Limited associations between specific meniscal pathology and other concurrent knee joint pathologies with presence of self-reported mechanical symptoms were found in patients undergoing meniscal surgery. The findings question the clinical importance of mechanical symptoms as an indicator for arthroscopy for specific meniscal tears with the specific aim to relieve such symptoms.

KW - Arthroscopy

KW - Knee joint

KW - Mechanical symptoms

KW - Meniscus

KW - Osteoarthritis

KW - Tibial meniscus injuries

U2 - 10.1016/j.jsams.2018.07.018

DO - 10.1016/j.jsams.2018.07.018

M3 - Journal article

C2 - 30100169

AN - SCOPUS:85051102583

VL - 22

SP - 151

EP - 157

JO - Journal of Science and Medicine in Sport

JF - Journal of Science and Medicine in Sport

SN - 1440-2440

IS - 2

ER -