Sports and Exercise Medicine, Queen Mary University of London, London, United Kingdom.
Department of Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit, Faculty of Medicine, Lund University, Lund, Sweden.
Clin J Sport Med. 2022 Sep 1;32(5):523-530. doi: 10.1097/JSM.0000000000001011. Epub 2022 Jan 6.
To assess the variation in changes in patient-reported outcomes 4 to 6 years after arthroscopic partial meniscectomy (APM).
Prospective cohort study.
Orthopedic departments at public hospitals.
Patients (n = 447) from the Knee Arthroscopy Cohort Southern Denmark undergoing APM.
All patients underwent APM.
Change in KOOS4 scores from baseline before surgery to ∼5 years (range 4-6 years) after surgery. KOOS4 is the average aggregated score of 4 of 5 of the Knee injury and Osteoarthritis Outcome Score (KOOS) excluding the activities of daily living subscale (minimal clinical important improvement ∼10 points). A mixed linear model adjusted for sex and body mass index was used to assess change from baseline to ∼5-year follow-up. Change in KOOS4 was divided into 5 categories based on change from baseline to ∼5-year follow-up: <0 points, 0 to 9 points, 10 to 19 points, 20 to 29 points, and ≥30 points.
On average, patient-reported outcomes continued to improve from baseline to ∼5-year follow-up (mean KOOS4 change: 26, 95% CI, 24-28). Proportions in the different response groups were <0 points (12%), 0 to 9 points (13%), 10 to 19 points (16%), 20 to 29 points (19%), and ≥30 points (40%), with no difference between younger (≤40 years, n = 75) and older (>40 years, n = 337) patients (P = 0.898).
Patient-reported outcomes on average improved up to ∼5 years after APM; however, large variability was observed. The similar variability in younger and older patients questions the assumption that younger patients with traumatic injuries experience larger benefits from APM.
评估关节镜下半月板部分切除术(APM)后 4 至 6 年患者报告结局的变化。
前瞻性队列研究。
公立医院的骨科系。
来自丹麦南部膝关节镜队列的患者(n=447),行 APM。
所有患者均行 APM。
手术前基线时 KOOS4 评分与术后约 5 年(4-6 年)的变化。KOOS4 是膝关节损伤和骨关节炎结局评分(KOOS)的 5 项中的 4 项(不包括日常生活活动量表)的平均综合评分(最小临床重要改善约 10 分)。采用混合线性模型,根据性别和体重指数调整,评估从基线到 5 年随访的变化。根据从基线到 5 年随访的变化,将 KOOS4 的变化分为 5 类:<0 分、0 至 9 分、10 至 19 分、20 至 29 分和≥30 分。
平均而言,患者报告的结果从基线到 5 年随访持续改善(平均 KOOS4 变化:26,95%CI,24-28)。不同反应组的比例分别为<0 分(12%)、0 至 9 分(13%)、10 至 19 分(16%)、20 至 29 分(19%)和≥30 分(40%),年轻患者(≤40 岁,n=75)和年长患者(>40 岁,n=337)之间无差异(P=0.898)。
APM 后平均 5 年内患者报告的结局有所改善;然而,观察到很大的变异性。年轻和年长患者的变异性相似,这对年轻创伤性损伤患者从 APM 中获得更大益处的假设提出了质疑。