Predictors of short-term recovery differ from those of long-term outcome after arthroscopic partial meniscectomy

Abstract

Purpose: The purpose of this study was to determine which patient clinical and demographic factors are associated with the short-term rate of recovery from arthroscopic partial meniscectomy in the year after surgery and how they differ from previously published associations with long-term outcome.

Methods: Depth of meniscal excision, involvement of 1 or both menisci, extent of meniscal tear, and extent of osteoarthritis were determined during surgery, and age, body mass index, and gender were recorded. Mixed-model repeated-measures analyses were used longitudinally to identify independent predictors of recovery, measured by prospectively assessing knee pain, knee function, and overall physical knee status preoperatively and at regular intervals throughout postoperative recovery.

Results: Neither advanced age nor increased body mass index had any influence on patient recovery over time, whereas gender was implicated, with women having significantly poorer recovery scores than men (P < .04). In addition, differences in variables indicating extent of meniscal tear and resection did not influence recovery scores over time, and the only surgical factor that impacted all 3 recovery variables was extent of osteoarthritis (P < .02).

Conclusions: We have shown that female gender and worse osteoarthritis are associated with a slower rate of short-term recovery from arthroscopic partial meniscectomy whereas age, obesity, and amount of meniscal tear/resection showed no association with rate of recovery throughout the first year postoperatively.

Level of evidence: Level I, high-quality prognostic prospective study (all patients were enrolled at the same point in their disease with more than 80% follow-up of enrolled patients).

Figure 1

Surgeon recorded location (A; in any of six clinically significant divisions (“zones”): the anterior horn, body, and posterior horn of each of the lateral and medial menisci) and depth (B; each zone divided into quarters along the width of the meniscus) of meniscus removed, as well as osteoarthritis by modified Outerbridge Score for medial, lateral, and patellar compartments (C).

Figure 2

Intraoperative arthroscopic images showing examples of depth of meniscus removed: 25% (A), 50% (5mm probe shown for scale) (B), and 100% (C).

Figure 3

Example data scoring sheets used during this study. Data collection forms were designed by epidemiologists and statisticians at a major university hospital.

Figure 3

Example data scoring sheets used during this study. Data collection forms were designed by epidemiologists and statisticians at a major university hospital.