Patient-reported symptoms and changes up to 1 year after meniscal surgery

Figures & data

Figure 1. Study flow.

Table 1. Patient characteristics at baseline

	All	≤ 40 years	> 40 years
Variables	(n = 641)	(n = 150)	(n = 491)
Age, years (SD)	49 (13.0)	31 (7.2)	55 (8.6)
Female, n (%)	280 (44)	50 (33)	230 (47)
BMI (SD)	27 (4.4)	26 (4.2)	28 (4.5)
Symptom onset, n (%)
Developed slowly over time	208 (32)	29 (19)	179 (36)
Developed as a result of
less severe incident	260 (41)	51 (34)	209 (43)
severe incident	173 (27)	70 (47)	103 (21)
Duration of symptoms, n (%)
0–3 months	129 (20)	41 (27)	88 (18)
4–6 months	181 (28)	24 (16)	157 (32)
7–12 months	135 (21)	31 (21)	104 (21)
13–24 months	94 (15)	20 (13)	74 (15)
Longer than 24 months	102 (16)	34 (23)	68 (14)
KOOS subscale scores, mean (SD)
Pain	54.9 (18)	58.9 (20)	53.6 (18)
Symptoms	60.0 (19)	60.6 (19)	59.8 (18)
ADL	63.7 (19)	69.8 (20)	61.8 (19)
Sport/Rec	26.3 (22)	31.1 (23)	24.9 (21)
QOL	41.6 (15)	40.2 (16)	42.0 (15)
Type of surgery, no. (%)
Resection	600 (94)	118 (79)	482 (98.)
Repair	33 (5.1)	24 (16)	9 (1.8)
Both	8 (1.2)	8 (5.3)	0 (0.0)

KOOS: The Knee injury and Osteoarthritis Outcome Score with scores ranging from 0 to 100 (worst to best scale);

ADL: function in daily living;

Sport/Rec: function in sport and recreation;

QOL: quality of life.

Figure 2. Prevalence (95% CI) and severity of the 5 most common clinical symptoms and five most common limitations and quality-of-life items in patients with a meniscal tear considered eligible for meniscal surgery (n = 641). Severity (color of the data points) is the most prevalent of the 5 levels of severity on the Knee Injury and Osteoarthritis Outcome Score (KOOS).

Table 2. Prevalence and severity of the 5 most common clinical symptoms in the full group and the subgroups at baseline^a

	All	≤ 40 years	> 40 years
	(n = 641)	(n = 150)	(n = 491)
Prevalence, n (%) [95% CI]
S2. Grinding, clicking or other	562 (88) [85–90]	135 (90) [84–94]	427 (87) [84–90]^b
S7. Stiffness later in the day	546 (85) [82–88]^b	114 (76) [69–82]^b	432 (88) [85–91]
P1. Knee pain in general	631 (98) [97–99]	147 (98) [95–99]	484 (99) [97–99]
P2. Pain twisting/pivoting knee	616 (96) [94–97]	141 (94) [89–97]	475 (97) [95–98]
P4. Pain bending knee fully	567 (89) [86–91]	131 (87) [81–92]	436 (89) [86–91]
P6. Pain going up or down stairs	590 (92) [90–94]	131 (87) [81–92]	459 (93) [91–95]
Severity^c (1/2/3/4), %
S2. Grinding, clicking or other	12/31/42/15	12/26/43/19	12/26/43/19
S7. Stiffness later in the day	34/43/22/1	43/33/22/2	31/46/22/1
P1. Knee pain in general	5/11/65/19	8/20/53/19	4/9/69/18
P2. Pain twisting/pivoting knee	14/31/43/12	18/28/38/16	13/32/44/11
P4. Pain bending knee fully	24/33/31/11	25/31/26/18	24/34/33/9
P6. Pain going up or down stairs	24/36/32/9	34/34/21/11	21/36/35/8

95% CI =95% confidence intervals.

a Letters and numbers in front of each variable refer to item identification from the Knee Injury and Osteo-­arthritis Outcome Score (KOOS).

b Not in top 5 for the group, only included as comparator for the other groups.

c Severity: ranging from 1 (best) to 4 (worst) is the KOOS response categories for each individual item.

Table 3. Prevalence and severity of the 5 most common functional limitations and quality-of-life items in the full group and the subgroups at baseline^a

	All	≤ 40 years	> 40 years
	(n = 641)	(n = 150)	(n = 491)
Prevalence, n (%) [95% CI]
A5. Difficulty bending to floor	619 (97) [95–98]	144 (96) [92–98]^d	475 (97) [95–98]
SP1. Difficulty squatting	626 (98) [96–99]	148 (99) [96–100]	478 (97) [96–98]
SP4. Difficulty twisting/pivoting knee	628 (98) [97–99]	144 (96) [92–98]^d	484 (99) [97–99]
SP5. Difficulty kneeling	626 (98) [96–99]	145 (97) [93–99]	481 (98) [96–99]
Q1. Often aware of knee problem	637 (99) [98–100]	149 (99) [97–100]	488 (99) [98–100]
Q3. Lack of knee confidence	611 (95) [93–97]^b	146 (97) [94–99]	465 (94) [92–96]^b
Severity^c (1/2/3/4), %
A5. Difficulty bending to floor	16/28/39/16	17/35/33/15	15/27/41/17
SP1. Difficulty squatting	8/18/37/37	11/18/36/34	8/17/37/38
SP2. Difficulty running	6/14/38/41	10/17/34/39	5/13/40/42
SP4. Difficulty twisting/pivoting knee	8/14/36/42	10/17/35/37	7/13/37/43
SP5. Difficulty kneeling	9/19/35/38	13/20/34/32	8/18/35/40
Q1. Often aware of knee problem	1/4/63/32	3/9/64/25	1/3/63/34
Q3. Lack of knee confidence	18/33/40/9	14/27/47/12	19/34/38/8

95% CI =95% confidence intervals.

a Letters and numbers in front of each variable refer to item identification from the Knee Injury and Osteo-­arthritis Outcome Score (KOOS).

b Not in top 5 for the group, only included as comparator for the other groups.

c Severity: ranging from 1 (best) to 4 (worst) is the KOOS response categories for each individual item.

d The prevalence was the same for these items, so both were included resulting in the young group having 6 most prevalent items.

Figure 3. Prevalence (95% CI) of the 5 self-reported clinical symptoms and limitations and quality-of-life items mostly improved at 12 months after arthroscopic meniscal surgery at baseline, 3, and 12 months in patients with a meniscal tear considered eligible for meniscal surgery (n = 557). Letters and numbers in front of each variable refer to item identification from KOOS. Q1: Often aware of knee problem; SP4: Difficulty twisting/pivoting; P1: Knee pain in general; A12: Difficulty lying in bed; and A10: Difficulty rising from bed.

Table 6. Outcome from baseline to 12 months for the 5 clinical symptoms and limitations and quality-of-life items mostly improved after arthroscopic surgery in the full group and for patients of 40 years of age or younger and patients older than 40 years of age^a

	All (n = 565)				≤ 40 years (n = 121)				> 40 years (n = 444)
	Base-line	12months	Diff.		Base-line	12months	Diff.		Base-line	12months	Diff.
Severity^b	n	n	p-value	Effect size	n	n	p-value	Effect size	n	n	p-value	Effect size
P1. Knee pain in general
0	10	124	< 0.001	–0.47	3	20	< 0.001	–0.44	7	104	< 0.001	–0.48
1	29	132			11	33			18	99
2	58	113			20	28			38	85
3	371	161			68	31			303	130
4	97	35			19	9			78	26
P6. Pain going up and down stairs
0	46	191	< 0.001	–0.42^c	17	46	< 0.001	–0.30^c	29	145	< 0.001	–0.45
1	125	158			38	32			87	126
2	185	134			37	26			148	108
3	169	71			22	13			147	58
4	40	11			7	4			33	7
A10. Difficulty rising from bed
0	131	347	< 0.001	–0.44	51	89	< 0.001	–0.39^c	80	258	< 0.001	–0.46
1	204	138			46	25			158	113
2	162	59			19	7			143	52
3	58	16			4	0			54	16
4	10	5			1	0			9	5
A12. Difficulty lying in bed (turning over, maintaining knee position)
0	89	302	< 0.001	–0.44	36	74	< 0.001	–0.34^c	53	228	< 0.001	–0.47
1	152	137			36	27			116	110
2	183	79			32	11			151	68
3	118	35			14	8			104	27
4	23	12			3	1			20	11
SP2. Difficulty running
0	23	106	< 0.001	–0.41^c	8	31	< 0.001	–0.43	15	75	< 0.001	–0.41^c
1	34	117			12	28			22	89
2	79	113			21	25			58	88
3	208	133			37	21			171	112
4	221	96			43	16			178	80
SP4. Difficulty twisting/pivoting knee
0	10	101	< 0.001	–0.43	4	27	< 0.001	–0.41	6	74	< 0.001	–0.44^c
1	43	122			13	27			30	95
2	85	121			25	29			60	92
3	198	123			39	22			159	101
4	229	98			40	16			189	82
Q1. Often aware of knee problem
0	3	51	< 0.001	–0.45	1	9	< 0.001	–0.40	2	42	< 0.001	–0.46
1	7	109			4	30			3	79
2	21	105			8	24			13	81
3	358	228			82	42			276	186
4	176	72			26	16			150	56
Q3. Lack of knee confidence
0	25	108	< 0.001	–0.39^c	3	19	< 0.001	–0.39	22	89	< 0.001	–0.39^c
1	94	206			14	35			80	171
2	183	120			36	33			147	87
3	216	116			56	30			160	86
4	47	15			12	4			35	11

a Letters and numbers in front of each variable refer to item identification from the Knee Injury and Osteoarthritis Outcome Score (KOOS).

b Severity: ranging from 0 (best) to 5 (worst) or 0 (best) to 4 (worst) is the response categories for each individual item.

The comparison of the paired data was done using Wilcoxon’s signed-rank test.

Effect sizes were calculated by the formula r = Z/√N_observations.

All comparisons between baseline and 12 months’ follow-up were significant (p-value <0.05).

c Not in top 5 for the group, only included as comparator for the other groups.