Conundrum of mechanical knee symptoms

Signifying feature of a meniscal tear?

Jonas Bloch Thorlund*, Kenneth Pihl, Nis Nissen, Uffe Jørgensen, Jakob Vium Fristed, L. Stefan Lohmander, Martin Englund

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Background: Mechanical knee symptoms are often considered important in the decision to perform knee arthroscopy on the suspicion of a meniscal tear. We investigated if presence of a meniscal tear at knee arthroscopy in adults is associated with presence of preoperative self-reported mechanical knee symptoms. Methods: We used data from Knee Arthroscopy Cohort Southern Denmark (KACS). KACS consists of patients aged 18 years or older referred to knee arthroscopy on the suspicion of a meniscal tear at four recruiting hospitals between 1 February 2013 and 31 January 2015. Of 1259 invited patients, 908 (72%) replied to the baseline questionnaire. With 91 patients excluded, the study sample consisted of 641 and 176 patients with and without a meniscal tear confirmed at surgery, respectively. Exposure was meniscal tear as determined by the knee surgeon during arthroscopy. Main outcomes were preoperative mechanical knee symptoms defined as self-reported catching/locking or self-reported inability to straighten knee fully. Results: 55% of all patients reported symptoms of catching/locking and 47% were unable to straighten their knee fully. Preoperative mechanical symptoms were equally prevalent in patients with and without a meniscal tear (prevalence ratio catching/locking 0.89, 95% CI 0.77 to 1.03, and inability to straighten knee fully, prevalence ratio 1.02, 95% CI 0.84 to 1.23). Interpretation: Patient-reported mechanical symptoms were equally common irrespective of presence or absence of a meniscal tear in patients undergoing arthroscopy for suspicion of a meniscal tear. Our findings suggest that mechanical knee symptoms have a limited value when considering indication for meniscal surgery. Trial registration number: NCT01871272; Results.

Original languageEnglish
JournalBritish Journal of Sports Medicine
Volume53
Issue number5
Pages (from-to)299-303
ISSN0306-3674
DOIs
Publication statusPublished - Mar 2019

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Knee
Denmark

Keywords

  • arthroscopy
  • epidemiology
  • knee
  • meniscal pathology
  • osteoarthritis

Cite this

Thorlund, Jonas Bloch ; Pihl, Kenneth ; Nissen, Nis ; Jørgensen, Uffe ; Fristed, Jakob Vium ; Lohmander, L. Stefan ; Englund, Martin. / Conundrum of mechanical knee symptoms : Signifying feature of a meniscal tear?. In: British Journal of Sports Medicine. 2019 ; Vol. 53, No. 5. pp. 299-303.
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title = "Conundrum of mechanical knee symptoms: Signifying feature of a meniscal tear?",
abstract = "Background: Mechanical knee symptoms are often considered important in the decision to perform knee arthroscopy on the suspicion of a meniscal tear. We investigated if presence of a meniscal tear at knee arthroscopy in adults is associated with presence of preoperative self-reported mechanical knee symptoms. Methods: We used data from Knee Arthroscopy Cohort Southern Denmark (KACS). KACS consists of patients aged 18 years or older referred to knee arthroscopy on the suspicion of a meniscal tear at four recruiting hospitals between 1 February 2013 and 31 January 2015. Of 1259 invited patients, 908 (72{\%}) replied to the baseline questionnaire. With 91 patients excluded, the study sample consisted of 641 and 176 patients with and without a meniscal tear confirmed at surgery, respectively. Exposure was meniscal tear as determined by the knee surgeon during arthroscopy. Main outcomes were preoperative mechanical knee symptoms defined as self-reported catching/locking or self-reported inability to straighten knee fully. Results: 55{\%} of all patients reported symptoms of catching/locking and 47{\%} were unable to straighten their knee fully. Preoperative mechanical symptoms were equally prevalent in patients with and without a meniscal tear (prevalence ratio catching/locking 0.89, 95{\%} CI 0.77 to 1.03, and inability to straighten knee fully, prevalence ratio 1.02, 95{\%} CI 0.84 to 1.23). Interpretation: Patient-reported mechanical symptoms were equally common irrespective of presence or absence of a meniscal tear in patients undergoing arthroscopy for suspicion of a meniscal tear. Our findings suggest that mechanical knee symptoms have a limited value when considering indication for meniscal surgery. Trial registration number: NCT01871272; Results.",
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Conundrum of mechanical knee symptoms : Signifying feature of a meniscal tear? / Thorlund, Jonas Bloch; Pihl, Kenneth; Nissen, Nis; Jørgensen, Uffe; Fristed, Jakob Vium; Lohmander, L. Stefan; Englund, Martin.

In: British Journal of Sports Medicine, Vol. 53, No. 5, 03.2019, p. 299-303.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Conundrum of mechanical knee symptoms

T2 - Signifying feature of a meniscal tear?

AU - Thorlund, Jonas Bloch

AU - Pihl, Kenneth

AU - Nissen, Nis

AU - Jørgensen, Uffe

AU - Fristed, Jakob Vium

AU - Lohmander, L. Stefan

AU - Englund, Martin

N1 - © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2019/3

Y1 - 2019/3

N2 - Background: Mechanical knee symptoms are often considered important in the decision to perform knee arthroscopy on the suspicion of a meniscal tear. We investigated if presence of a meniscal tear at knee arthroscopy in adults is associated with presence of preoperative self-reported mechanical knee symptoms. Methods: We used data from Knee Arthroscopy Cohort Southern Denmark (KACS). KACS consists of patients aged 18 years or older referred to knee arthroscopy on the suspicion of a meniscal tear at four recruiting hospitals between 1 February 2013 and 31 January 2015. Of 1259 invited patients, 908 (72%) replied to the baseline questionnaire. With 91 patients excluded, the study sample consisted of 641 and 176 patients with and without a meniscal tear confirmed at surgery, respectively. Exposure was meniscal tear as determined by the knee surgeon during arthroscopy. Main outcomes were preoperative mechanical knee symptoms defined as self-reported catching/locking or self-reported inability to straighten knee fully. Results: 55% of all patients reported symptoms of catching/locking and 47% were unable to straighten their knee fully. Preoperative mechanical symptoms were equally prevalent in patients with and without a meniscal tear (prevalence ratio catching/locking 0.89, 95% CI 0.77 to 1.03, and inability to straighten knee fully, prevalence ratio 1.02, 95% CI 0.84 to 1.23). Interpretation: Patient-reported mechanical symptoms were equally common irrespective of presence or absence of a meniscal tear in patients undergoing arthroscopy for suspicion of a meniscal tear. Our findings suggest that mechanical knee symptoms have a limited value when considering indication for meniscal surgery. Trial registration number: NCT01871272; Results.

AB - Background: Mechanical knee symptoms are often considered important in the decision to perform knee arthroscopy on the suspicion of a meniscal tear. We investigated if presence of a meniscal tear at knee arthroscopy in adults is associated with presence of preoperative self-reported mechanical knee symptoms. Methods: We used data from Knee Arthroscopy Cohort Southern Denmark (KACS). KACS consists of patients aged 18 years or older referred to knee arthroscopy on the suspicion of a meniscal tear at four recruiting hospitals between 1 February 2013 and 31 January 2015. Of 1259 invited patients, 908 (72%) replied to the baseline questionnaire. With 91 patients excluded, the study sample consisted of 641 and 176 patients with and without a meniscal tear confirmed at surgery, respectively. Exposure was meniscal tear as determined by the knee surgeon during arthroscopy. Main outcomes were preoperative mechanical knee symptoms defined as self-reported catching/locking or self-reported inability to straighten knee fully. Results: 55% of all patients reported symptoms of catching/locking and 47% were unable to straighten their knee fully. Preoperative mechanical symptoms were equally prevalent in patients with and without a meniscal tear (prevalence ratio catching/locking 0.89, 95% CI 0.77 to 1.03, and inability to straighten knee fully, prevalence ratio 1.02, 95% CI 0.84 to 1.23). Interpretation: Patient-reported mechanical symptoms were equally common irrespective of presence or absence of a meniscal tear in patients undergoing arthroscopy for suspicion of a meniscal tear. Our findings suggest that mechanical knee symptoms have a limited value when considering indication for meniscal surgery. Trial registration number: NCT01871272; Results.

KW - arthroscopy

KW - epidemiology

KW - knee

KW - meniscal pathology

KW - osteoarthritis

U2 - 10.1136/bjsports-2018-099431

DO - 10.1136/bjsports-2018-099431

M3 - Journal article

VL - 53

SP - 299

EP - 303

JO - British Journal of Sports Medicine

JF - British Journal of Sports Medicine

SN - 0306-3674

IS - 5

ER -