Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Department of Orthopaedics, Lillebaelt Hospital, Kolding, Denmark.
Br J Sports Med. 2019 Mar;53(5):299-303. doi: 10.1136/bjsports-2018-099431. Epub 2018 Aug 31.
Mechanical knee symptoms are often considered important in the decision to perform knee arthroscopy on the suspicion of a meniscal tear. We investigated if presence of a meniscal tear at knee arthroscopy in adults is associated with presence of preoperative self-reported mechanical knee symptoms.
We used data from Knee Arthroscopy Cohort Southern Denmark (KACS). KACS consists of patients aged 18 years or older referred to knee arthroscopy on the suspicion of a meniscal tear at four recruiting hospitals between 1 February 2013 and 31 January 2015. Of 1259 invited patients, 908 (72%) replied to the baseline questionnaire. With 91 patients excluded, the study sample consisted of 641 and 176 patients and a meniscal tear confirmed at surgery, respectively. Exposure was meniscal tear as determined by the knee surgeon during arthroscopy. Main outcomes were preoperative mechanical knee symptoms defined as self-reported catching/locking or self-reported inability to straighten knee fully.
55% of all patients reported symptoms of catching/locking and 47% were unable to straighten their knee fully. Preoperative mechanical symptoms were equally prevalent in patients and a meniscal tear (prevalence ratio catching/locking 0.89, 95% CI 0.77 to 1.03, and inability to straighten knee fully, prevalence ratio 1.02, 95% CI 0.84 to 1.23).
Patient-reported mechanical symptoms were equally common irrespective of presence or absence of a meniscal tear in patients undergoing arthroscopy for suspicion of a meniscal tear. Our findings suggest that mechanical knee symptoms have a limited value when considering indication for meniscal surgery.
NCT01871272; Results.
机械性膝关节症状常被认为在怀疑半月板撕裂而进行膝关节镜检查时是重要的决策因素。我们研究了成年人膝关节镜检查中半月板撕裂的存在是否与术前自我报告的机械性膝关节症状的存在有关。
我们使用了丹麦南部膝关节镜检查队列（Knee Arthroscopy Cohort Southern Denmark，KACS）的数据。KACS 包括在 2013 年 2 月 1 日至 2015 年 1 月 31 日期间，在四家招募医院因怀疑半月板撕裂而接受膝关节镜检查的年龄在 18 岁或以上的患者。在邀请的 1259 名患者中，有 908 名（72%）回复了基线问卷。排除 91 名患者后，研究样本包括分别在手术中证实有半月板撕裂的 641 名和 176 名患者。暴露因素为膝关节镜检查中膝关节外科医生确定的半月板撕裂。主要结局为术前机械性膝关节症状，定义为自我报告的卡锁/锁定或自我报告的无法完全伸直膝关节。
所有患者中有 55%报告有卡锁/锁定症状，47%无法完全伸直膝关节。有半月板撕裂的患者和无半月板撕裂的患者术前机械性症状的发生率相同（卡锁/锁定的患病率比为 0.89，95%CI 为 0.77 至 1.03，无法完全伸直膝关节的患病率比为 1.02，95%CI 为 0.84 至 1.23）。
在因怀疑半月板撕裂而接受膝关节镜检查的患者中，无论是否存在半月板撕裂，患者报告的机械性膝关节症状都同样常见。我们的研究结果表明，在考虑半月板手术的适应证时，机械性膝关节症状的价值有限。
NCT01871272；结果。
