Predictors of residual mechanical symptoms after meniscus surgery: data from the maks group

Abstract

Purpose: To investigate predictors of residual mechanical symptoms after arthroscopic meniscus surgery. Methods: Patients who underwent solely meniscus surgery registered in the multicenter arthroscopic knee surgery (MAKS) study, a prospective multicenter cohort study, were included in this study. 61 patients with mechanical symptoms met the inclusion criteria; not a discoid meniscus and has not undergone other surgeries in the involved knee within 1 year. Mechanical symptoms (MS), such as the sensation of knee catching and/or locking, were assessed using items from Knee injury and Osteoarthritis Outcome score (KOOS) symptoms subscale. They were divided into 2 groups according to the presence of mechanical symptoms at 1 year postoperatively (Figure 1). Patients who reported residual mechanical symptoms at 1 year postoperatively were classified into residual MS group, whereas patients who improved mechanical symptoms were classified into improved MS group. Age, gender, physical findings, type of surgery (meniscectomy and/or repair), tear location, meniscal tissue and cartilage quality, patients’ subjective satisfaction and KOOS were analyzed between-group difference. Results: 26 patients (42.6%) reported residual mechanical symptoms and were classified into residual MS group, whereas 35 patients improved mechanical symptoms and were classified into improved MS group. Residual MS group was higher in the positive ratio of McMurray test preoperatively than improved MS group (Table 1, P = .026). There were more cases of severe cartilage damage (ICRS glade >3) in residual MS group than improved MS group (Table 3, P = .013). There was no significant difference in age, gender, type of surgery, tear location, and meniscal quality between the two groups. Residual MS group showed significantly lower score in patients’ satisfaction score and KOOS at 1 year postoperatively compared with improved MS group (Table 4, P < .05). Conclusions: Our data suggested that severe cartilage damage is predictors of residual mechanical symptoms after the meniscus surgery. In addition, patients with remaining symptoms reported less satisfaction scores after surgery. To use only patients-reported mechanical symptoms as indication for meniscus surgery may be inappropriate.View Large Image Figure ViewerDownload Hi-res image Download (PPT)View Large Image Figure ViewerDownload Hi-res image Download (PPT)View Large Image Figure ViewerDownload Hi-res image Download (PPT)View Large Image Figure ViewerDownload Hi-res image Download (PPT)