This article says that tear size, tear location, and cartilage damage does not always correlate with the amount of pain that patients report. ~ Dr. Broussard
What are the findings?
-
Meniscal pathology features such as tear type, tear size and tear location identified at arthroscopy were not associated with preoperative self-reported knee pain and function in patients undergoing arthroscopic meniscal surgery.
-
Other structural knee joint pathologies found at surgery, such as cartilage damage, were not associated with preoperative self-reported knee pain and function.
-
Increasing age, female gender and greater body mass index were modestly associated with poorer self-reported outcomes.
How might it impact on clinical practice in the future?
-
These findings question inferences made about relationships between structural knee pathology and patient perceived symptoms.
-
Our findings question the role of arthroscopy to address structural pathology as a means to improve patient-reported outcomes and the construct of specific subgroups of patients, based on meniscal and other structural pathology, who may benefit from meniscal surgery.
Structural pathology is not related to patient-reported pain and function in patients undergoing meniscal surgery – Full Text Article
Br J Sports Med 2017;51:525-530.
Simon Maretti Tornbjerg
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.