Patient-reported symptoms and changes up to 1 year after meniscal surgery

Abstract

Background and purpose - Detailed information on the symptoms and limitations that patients with meniscal tears experience is lacking. This study was undertaken to map the most prevalent self-reported symptoms and functional limitations among patients undergoing arthroscopic meniscal surgery and investigate which symptoms and limitations had improved most at 1 year after surgery. Patients and methods - Patients aged 18-76 years from the Knee Arthroscopy Cohort Southern Denmark (KACS) undergoing arthroscopic meniscal surgery were included in this analysis of individual subscale items from the Knee Injury and Osteoarthritis Outcome Score and 1 question on knee stability. Severity of each item was scored as none, mild, moderate, severe, or extreme. Improvements were evaluated using Wilcoxon's signed-rank test and effect size (ES). Results - The most common symptoms were knee grinding and clicking, knee pain in general, pain when twisting and bending the knee and climbing stairs (88-98%), while the most common functional limitations were difficulty bending to the floor, squatting, twisting, kneeling, and knee awareness (97-99%). Knee pain in general and knee awareness improved most 1 year after meniscal surgery (ES -0.47 and -0.45; p < 0.001), while knee instability and general knee difficulties improved least (ES 0.10 and -0.08; p < 0.006). Interpretation - Adults undergoing surgery for a meniscal tear commonly report clinical symptoms and functional limitations related to their daily activities. Moderate improvements were observed in some symptoms and functional limitations and small to no improvement in others at 1 year after surgery. These findings can assist the clinical discussion of symptoms, treatments, and patients' expectations.

Figure 1.

Study flow.

Figure 2.

Prevalence (95% CI) and severity of the 5 most common clinical symptoms and five most common limitations and quality-of-life items in patients with a meniscal tear considered eligible for meniscal surgery (n = 641). Severity (color of the data points) is the most prevalent of the 5 levels of severity on the Knee Injury and Osteoarthritis Outcome Score (KOOS).

Figure 3.

Prevalence (95% CI) of the 5 self-reported clinical symptoms and limitations and quality-of-life items mostly improved at 12 months after arthroscopic meniscal surgery at baseline, 3, and 12 months in patients with a meniscal tear considered eligible for meniscal surgery (n = 557). Letters and numbers in front of each variable refer to item identification from KOOS. Q1: Often aware of knee problem; SP4: Difficulty twisting/pivoting; P1: Knee pain in general; A12: Difficulty lying in bed; and A10: Difficulty rising from bed.