Mechanical Symptoms Research Articles

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

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)

Change in patient-reported outcomes in patients with and without mechanical symptoms undergoing arthroscopic meniscal surgery: A prospective cohort study

Patients with degenerative or traumatic meniscal tears are at high risk of developing knee osteoarthritis. We investigated if younger (≤40 years) and older (>40 years) patients with preoperative mechanical symptoms (MS) improved more in patient-reported outcomes after meniscal surgery than those without MS. Patients from Knee Arthroscopy Cohort Southern Denmark (KACS) undergoing arthroscopic surgery for a meniscal tear completed online questionnaires before surgery, and at 12 and 52 weeks follow-up. Questionnaires included self-reported presence of MS (i.e., sensation of catching and/or locking) and the Knee injury and Osteoarthritis Outcome Score (KOOS). We analyzed between-group differences in change in KOOS4 from baseline to 52 weeks, using an adjusted mixed linear model. 150 younger patients (mean age 31 (SD 7), 67% men) and 491 older patients (mean age 54 (SD 9), 53% men) constituted the baseline cohorts. Patients with MS generally had worse self-reported outcomes before surgery. At 52 weeks follow-up, younger patients with preoperative MS had improved more in KOOS4 scores than younger patients without preoperative MS (adjusted mean difference 10.5, 95% CI: 4.3, 16.6), but did not exceed the absolute postoperative KOOS4 scores observed for those without MS. No difference in improvement was observed between older patients with or without MS (adjusted mean difference 0.7, 95% CI:-2.6, 3.9). Younger patients (≤40 years) with preoperative MS experienced greater improvements after arthroscopic surgery compared to younger patients without MS. Our observational study result needs to be confirmed in randomized trials.