Format

Send to

Choose Destination
Orthop J Sports Med. 2019 Apr 25;7(4):2325967119837940. doi: 10.1177/2325967119837940. eCollection 2019 Apr.

Predictive Factors and Duration to Return to Sport After Isolated Meniscectomy.

Author information

1
Department of Orthopaedic Surgery, Westchester Medical Center, Valhalla, New York, USA.
2
Department of Orthopaedic Surgery, Wake Forest University, Winston-Salem, North Carolina, USA.
3
Department of Orthopaedic Surgery, Loma Linda University Medical Center, Loma Linda, California, USA.
4
Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, USA.
5
Department of Orthopaedic Surgery, Northwestern University, Chicago, Illinois, USA.

Abstract

Background:

Return to sport (RTS) after meniscectomy is an important metric for young, active patients. However, the impact of the duration from surgery to RTS on clinical outcomes is not fully understood and is not reflected in outcome scores.

Purpose:

To establish when patients RTS after meniscectomy and to determine predictive measures for the ability to return to their preinjury activity.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

All patients undergoing meniscectomy between 2016 and 2017 from a single institution were assessed for inclusion. RTS, type of activity, and level of function upon returning were obtained. The minimal clinically important difference (MCID), substantial clinical benefit, and patient acceptable symptom state (PASS) were calculated for the Knee injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) questionnaire using anchor-based and distribution-based approaches. Preoperative knee-specific and generic quality-of-life scores were analyzed to determine their predictive power of RTS. A multivariate logistical analysis was also performed to determine which demographic variables corresponded to RTS.

Results:

Overall, 94 patients (mean age, 51.0 ± 11.1 years) who underwent meniscectomy participated in sports within 6 months of surgery. Of these patients, 76.6% returned to sport without permanent restrictions at a mean of 8.6 ± 6.9 weeks postoperatively. RTS rates for low-, medium-, and high-intensity activities were 75.0%, 70.0%, and 82.5%, respectively. RTS was associated with achieving the PASS for the KOOS-Physical Function short form (PS), KOOS-Pain, and KOOS-Sports (P = .004, P = .007, and P = .006, respectively) but not for the IKDC questionnaire (P = .3). Achieving the MCID was associated with RTS for the KOOS-Sports, KOOS-Pain, and IKDC questionnaire (P < .001, P = .03, and P = .001, respectively). There was no preoperative or intraoperative variable that was predictive of RTS. Preoperative KOOS-PS scores ≥37.8 (area under the curve = 76.3%) and KOOS-Pain scores ≥51.4 (area under the curve = 72.5%) were predictive of RTS.

Conclusion:

Approximately 77% of patients returned to sport after meniscectomy at a mean of 2 months postoperatively. The level of activity intensity did not significantly alter the rate of RTS. Higher preoperative scores on the KOOS-PS and KOOS-Pain were predictive of RTS. Identifying these factors allows physicians to counsel patients on expected outcomes after meniscectomy.

KEYWORDS:

meniscectomy; minimal clinically important difference; patient acceptable symptom state; return to sport; substantial clinical benefit

Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: B.J.C. has received research support from Aesculap/B. Braun, Arthrex, Geistlich, National Institutes of Health, Sanofi-Aventis, and Zimmer Biomet; has received educational support from Arthrex; has received consulting fees from Anika Therapeutics, Arthrex, Bioventus, Flexion, Geistlich, Genzyme, Pacira Pharmaceuticals, Smith & Nephew, Vericel, and Zimmer Biomet; has received speaking fees from Arthrex, Carticept Medical, and LifeNet Health; has received hospitality payments from DePuy and GE Healthcare; receives royalties from Arthrex, DJ Orthopedics, Elsevier, Encore Medical, and Operative Techniques in Sports Medicine; and has stock/stock options in Aqua Boom, Biometrix, GiteliScope, Ossio, and Regentis. B.F. has received research support from Arthrex and Stryker; has received educational/fellowship support from Medwest, Smith & Nephew, and Ossur; has received consulting fees from Sonoma Orthopedics and Stryker; has received honoraria from Arthrosurface; receives royalties from Elsevier; and has stock/stock options in Jace Medical. N.N.V. has received research support from Arthrex, Arthrosurface, DJ Orthopedics, Ossur, Athletico, ConMed Linvatec, Miomed, and Mitek; has received educational support from Medwest; has received consulting fees from Arthrex, Medacta, Minivasive, Orthospace, and Smith & Nephew; has received speaking fees from Pacira Pharmaceuticals; receives royalties from Arthroscopy, Smith & Nephew, and Vindico Medical Education–Orthopedics Hyperguide; and has stock/stock options in CyMedica, Minivasive, and Omeros. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Supplemental Content

Full text links

Icon for PubMed Central
Loading ...
Support Center