Structural pathology is not related to patient-reported pain and function in patients undergoing meniscal surgery. Tornbjerg, S. M.; Nissen, N.; Englund, M.; Jorgensen, U.; Schjerning, J.; Lohmander, L. S.; and Thorlund, J. B.
doi  abstract   bibtex   
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.
@article{tornbjerg_structural_2016,
	title = {Structural pathology is not related to patient-reported pain and function in patients undergoing meniscal surgery.},
	rights = {Published by the {BMJ} Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/},
	issn = {1473-0480 0306-3674},
	doi = {10.1136/bjsports-2016-096456},
	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.},
	journaltitle = {British journal of sports medicine},
	shortjournal = {Br J Sports Med},
	author = {Tornbjerg, Simon Maretti and Nissen, Nis and Englund, Martin and Jorgensen, Uffe and Schjerning, Jeppe and Lohmander, L. Stefan and Thorlund, Jonas Bloch},
	date = {2016-09-16},
	pmid = {27638845},
	keywords = {Arthroscopy, Arthroscopy, Knee, Knee, Meniscus, Meniscus, Surgery, Surgery}
}
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