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Ochsner J. 2018 Summer;18(2):126-130. doi: 10.31486/toj.17.0040.

Knee Range of Motion as a Discriminatory Tool Indicating Potential Meniscal Tears.

Author information

1
School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA.
2
Department of Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA.
3
Robert Wood Johnson Medical School, Rutgers, Piscataway, NJ.
4
Department of Orthopedics, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA.

Abstract

Background:

Primary care physicians often encounter patients with knee pain and are faced with the dilemma of whether to refer patients to a specialist. Meniscal tears are the most common intraarticular knee injury but are challenging to accurately diagnose because of a lack of quantitative, accurate, and easy-to-administer tests. We conducted a retrospective medical record review to evaluate whether measurement of knee range of motion (ROM) via goniometry could discriminate between healthy and meniscus-altered knees.

Methods:

A total of 110 adult patients met the inclusion criteria: age ≥18 years; no history of contralateral knee pain, injury, or surgery; ROM data collected using a goniometer on both knees at the time of diagnosis; and a confirmed diagnosis of meniscus tear via magnetic resonance imaging. The following variables were obtained from medical records: age, sex, body mass index (BMI), ROM for both knees, surgical treatment, insurance coverage, Ahlbäck x-ray grades, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Oxford Knee Score (OKS).

Results:

The majority of patients (96.4%) exhibited a ≥10° difference in flexion between asymptomatic and symptomatic knees. No significant relationships were observed between age, BMI, and the decision to undergo surgery and the difference in flexion or extension ROM. Both the WOMAC and the OKS were significantly correlated with the degree of loss of flexion ROM.

Conclusion:

The results suggest that knee flexion ROM may be a valuable tool for determining which patients presenting with new-onset ipsilateral knee pain should be referred to a specialist. Further investigation to determine the reliability and accuracy of knee ROM as a screening measure is warranted.

KEYWORDS:

Arthrometry–articular; diagnosis; range of motion–articular; referral and consultation; tibial meniscus injuries

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