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Jonas Bloch Thorlund - One of the best experts on this subject based on the ideXlab platform.

  • importance of patellofemoral and tibiofemoral cartilage lesions on trajectory of self reported outcomes in patients at high risk of knee oa 4 6 years follow up of patients undergoing Meniscal Surgery
    Osteoarthritis and Cartilage, 2021
    Co-Authors: Martin Englund, L S Lohmander, Erin M Macri, Adam G Culvenor, K Pihl, C Varnum, Roland Knudsen, Jonas Bloch Thorlund
    Abstract:

    Objective: We evaluated whether patient-reported outcome trajectories (i.e., changes over time) differed by intraoperative compartmental cartilage lesion pattern over 4–6 years following arthroscopic Meniscal Surgery. Methods: In this ancillary study of the Knee Arthroscopy Cohort Southern Denmark cohort, we intraoperatively categorized cartilage lesions as isolated patellofemoral, isolated tibiofemoral, or combined patellofemoral/tibiofemoral. Participants completed the Knee injury and Osteoarthritis Outcome Score (KOOS) pre-operatively, at 3 and 12 months, and at 4–6 years post-operatively and reported overall satisfaction at final follow-up. Our main outcome was KOOS4 (grand mean of four subscale means). We evaluated whether KOOS4 scores changed over time according to cartilage lesion patterns using adjusted mixed linear regression. We also estimated probability of treatment satisfaction using logistic regression. Results: Of 630 participants with complete cartilage scores, 280 (44%) were women, mean (standard deviation) age was 49 (13) years, and BMI was 27.3 (4.4) kg/m2. KOOS4 scores at baseline were slightly lower in all lesion groups compared to the no lesion group, yet only the combined group was statistically significantly lower. KOOS4 trajectories were similar across cartilage lesion patterns, but by final follow-up, adjusted mean KOOS4 scores were 6.8 (95% CI 2.2, 11.4) to 9.8 (1.1, 18.5) points lower in groups with cartilage lesions compared to the no lesion group. Probability of patient-reported satisfaction did not differ statistically by group. Conclusions: Though KOOS4 scores were slightly lower in groups with arthroscopically assessed cartilage lesions compared to the no lesion group, trajectories were similar across all groups.

  • cut off values to interpret short term treatment outcomes after arthroscopic Meniscal Surgery measured with the knee injury and osteoarthritis outcome score
    Journal of Orthopaedic & Sports Physical Therapy, 2021
    Co-Authors: Julie Ronne Pedersen, Jonas Bloch Thorlund, Ewa M Roos, Berend Terluin, Lina Holm Ingelsrud
    Abstract:

    Objective To determine the proportions of patients who (1) perceived their symptoms to be satisfactory, (2) perceived their treatment to have failed, or (3) perceived that they improved to an impor...

  • wild goose chase no predictable patient subgroups benefit from Meniscal Surgery patient reported outcomes of 641 patients 1 year after Surgery
    British Journal of Sports Medicine, 2020
    Co-Authors: Kenneth Pihl, Nis Nissen, Uffe Jørgensen, Joie Ensor, George Peat, Martin Englund, Stefan Lohmander, Jakob Vium Fristed, Jonas Bloch Thorlund
    Abstract:

    Background Despite absence of evidence of a clinical benefit of arthroscopic partial meniscectomy (APM), many surgeons claim that subgroups of patients benefit from APM. Objective We developed a prognostic model predicting change in patient-reported outcome 1 year following arthroscopic Meniscal Surgery to identify such subgroups. Methods We included 641 patients (age 48.7 years (SD 13), 56% men) undergoing arthroscopic Meniscal Surgery from the Knee Arthroscopy Cohort Southern Denmark. 18 preoperative factors identified from literature and/or orthopaedic surgeons (patient demographics, medical history, symptom onset and duration, knee-related symptoms, etc) were combined in a multivariable linear regression model. The outcome was change in Knee injury and Osteoarthritis Outcome Score (KOOS4) (average score of 4 of 5 KOOS subscales excluding the activities of daily living subscale) from preSurgery to 52 weeks after Surgery. A positive KOOS4 change score constitutes improvement. Prognostic performance was assessed using R2 statistics and calibration plots and was internally validated by adjusting for optimism using 1000 bootstrap samples. Results Patients improved on average 18.6 (SD 19.7, range −38.0 to 87.8) in KOOS4. The strongest prognostic factors for improvement were (1) no previous Meniscal Surgery on index knee and (2) more severe preoperative knee-related symptoms. The model’s overall predictive performance was low (apparent R2=0.162, optimism adjusted R2=0.080) and it showed poor calibration (calibration-in-the-large=0.205, calibration slope=0.772). Conclusion Despite combining a large number of preoperative factors presumed clinically relevant, change in patient-reported outcome 1 year following Meniscal Surgery was not predictable. This essentially quashes the existence of ‘subgroups’ with certain characteristics having a particularly favourable outcome after Meniscal Surgery. Trial registration number NCT01871272.

  • change in patient reported outcomes in patients with and without mechanical symptoms undergoing arthroscopic Meniscal Surgery a prospective cohort study
    Osteoarthritis and Cartilage, 2018
    Co-Authors: Kenneth Pihl, Nis Nissen, Uffe Jørgensen, Martin Englund, Jeppe Schjerning, Aleksandra Turkiewicz, L S Lohmander, Jonas Bloch Thorlund
    Abstract:

    Summary Objective Patients with degenerative or traumatic Meniscal tears are at high risk of developing knee osteoarthritis. We investigated if younger (≤40 years) and older (>40 years) patients with preoperative mechanical symptoms (MS) improved more in patient-reported outcomes after Meniscal Surgery than those without MS. Design Patients from Knee Arthroscopy Cohort Southern Denmark (KACS) undergoing arthroscopic Surgery for a Meniscal tear completed online questionnaires before Surgery, and at 12 and 52 weeks follow-up. Questionnaires included self-reported presence of MS (i.e., sensation of catching and/or locking) and the Knee injury and Osteoarthritis Outcome Score (KOOS). We analyzed between-group differences in change in KOOS4 from baseline to 52 weeks, using an adjusted mixed linear model. Results 150 younger patients (mean age 31 (SD 7), 67% men) and 491 older patients (mean age 54 (SD 9), 53% men) constituted the baseline cohorts. Patients with MS generally had worse self-reported outcomes before Surgery. At 52 weeks follow-up, younger patients with preoperative MS had improved more in KOOS4 scores than younger patients without preoperative MS (adjusted mean difference 10.5, 95% CI: 4.3, 16.6), but did not exceed the absolute postoperative KOOS4 scores observed for those without MS. No difference in improvement was observed between older patients with or without MS (adjusted mean difference 0.7, 95% CI: −2.6, 3.9). Conclusions Younger patients (≤40 years) with preoperative MS experienced greater improvements after arthroscopic Surgery compared to younger patients without MS. Our observational study result needs to be confirmed in randomized trials.

  • 4 change in patient reported outcomes in patients with and without mechanical symptoms undergoing arthroscopic Meniscal Surgery a prospective cohort study
    British Journal of Sports Medicine, 2018
    Co-Authors: Kenneth Pihl, Nis Nissen, Uffe Jørgensen, Martin Englund, Stefan Lohmander, Jeppe Schjerning, Aleksandra Turkiewicz, Jonas Bloch Thorlund
    Abstract:

    Introduction Mechanical symptoms are considered an important indication for Meniscal Surgery. We investigated if young (≤40 years) and older (>40 years) patients, respectively, with preoperative mechanical symptoms improved more in patient-reported outcomes after Meniscal Surgery than those without mechanical symptoms. Materials and methods Patients from Knee Arthroscopy Cohort Southern Denmark (KACS) undergoing arthroscopic Meniscal Surgery between February 2013 and January 2015 completed online questionnaires pre-Surgery, and at 12 and 52 weeks follow-up. Questionnaires included self-reported presence of mechanical symptoms (i.e. sensation of catching and/or locking) and the Knee Injury and Osteoarthritis Outcome Score (KOOS). Between-group differences in change in 4 of 5 KOOS subscales (KOOS4) from baseline to 52 weeks were analysed using an adjusted mixed linear model. Results 150 young patients (mean age 31 (SD 7), 67% men) and 491 older patients (mean age 54 (SD 9), 53% men) constituted the baseline cohorts. In general, patients with mechanical symptoms had worse self-reported outcomes before Surgery. At 52 weeks follow-up, young patients with preoperative mechanical symptoms had improved more in KOOS4 scores than young patients without preoperative mechanical symptoms (adjusted mean difference 10.5, 95% CI: 4.3 to 16.6), but did not exceed their absolute KOOS4 scores. No essential difference in improvement was observed between older patients with or without mechanical symptoms (adjusted mean difference 0.7, 95% CI: −2.6 to 3.9). Conclusion Young patients (≤40 years) with preoperative mechanical symptoms experienced greater improvements after arthroscopic Meniscal Surgery compared to young patients without mechanical symptoms. Randomised controlled trials are needed to confirm this potential subgroup benefit.

Martin Englund - One of the best experts on this subject based on the ideXlab platform.

  • importance of patellofemoral and tibiofemoral cartilage lesions on trajectory of self reported outcomes in patients at high risk of knee oa 4 6 years follow up of patients undergoing Meniscal Surgery
    Osteoarthritis and Cartilage, 2021
    Co-Authors: Martin Englund, L S Lohmander, Erin M Macri, Adam G Culvenor, K Pihl, C Varnum, Roland Knudsen, Jonas Bloch Thorlund
    Abstract:

    Objective: We evaluated whether patient-reported outcome trajectories (i.e., changes over time) differed by intraoperative compartmental cartilage lesion pattern over 4–6 years following arthroscopic Meniscal Surgery. Methods: In this ancillary study of the Knee Arthroscopy Cohort Southern Denmark cohort, we intraoperatively categorized cartilage lesions as isolated patellofemoral, isolated tibiofemoral, or combined patellofemoral/tibiofemoral. Participants completed the Knee injury and Osteoarthritis Outcome Score (KOOS) pre-operatively, at 3 and 12 months, and at 4–6 years post-operatively and reported overall satisfaction at final follow-up. Our main outcome was KOOS4 (grand mean of four subscale means). We evaluated whether KOOS4 scores changed over time according to cartilage lesion patterns using adjusted mixed linear regression. We also estimated probability of treatment satisfaction using logistic regression. Results: Of 630 participants with complete cartilage scores, 280 (44%) were women, mean (standard deviation) age was 49 (13) years, and BMI was 27.3 (4.4) kg/m2. KOOS4 scores at baseline were slightly lower in all lesion groups compared to the no lesion group, yet only the combined group was statistically significantly lower. KOOS4 trajectories were similar across cartilage lesion patterns, but by final follow-up, adjusted mean KOOS4 scores were 6.8 (95% CI 2.2, 11.4) to 9.8 (1.1, 18.5) points lower in groups with cartilage lesions compared to the no lesion group. Probability of patient-reported satisfaction did not differ statistically by group. Conclusions: Though KOOS4 scores were slightly lower in groups with arthroscopically assessed cartilage lesions compared to the no lesion group, trajectories were similar across all groups.

  • wild goose chase no predictable patient subgroups benefit from Meniscal Surgery patient reported outcomes of 641 patients 1 year after Surgery
    British Journal of Sports Medicine, 2020
    Co-Authors: Kenneth Pihl, Nis Nissen, Uffe Jørgensen, Joie Ensor, George Peat, Martin Englund, Stefan Lohmander, Jakob Vium Fristed, Jonas Bloch Thorlund
    Abstract:

    Background Despite absence of evidence of a clinical benefit of arthroscopic partial meniscectomy (APM), many surgeons claim that subgroups of patients benefit from APM. Objective We developed a prognostic model predicting change in patient-reported outcome 1 year following arthroscopic Meniscal Surgery to identify such subgroups. Methods We included 641 patients (age 48.7 years (SD 13), 56% men) undergoing arthroscopic Meniscal Surgery from the Knee Arthroscopy Cohort Southern Denmark. 18 preoperative factors identified from literature and/or orthopaedic surgeons (patient demographics, medical history, symptom onset and duration, knee-related symptoms, etc) were combined in a multivariable linear regression model. The outcome was change in Knee injury and Osteoarthritis Outcome Score (KOOS4) (average score of 4 of 5 KOOS subscales excluding the activities of daily living subscale) from preSurgery to 52 weeks after Surgery. A positive KOOS4 change score constitutes improvement. Prognostic performance was assessed using R2 statistics and calibration plots and was internally validated by adjusting for optimism using 1000 bootstrap samples. Results Patients improved on average 18.6 (SD 19.7, range −38.0 to 87.8) in KOOS4. The strongest prognostic factors for improvement were (1) no previous Meniscal Surgery on index knee and (2) more severe preoperative knee-related symptoms. The model’s overall predictive performance was low (apparent R2=0.162, optimism adjusted R2=0.080) and it showed poor calibration (calibration-in-the-large=0.205, calibration slope=0.772). Conclusion Despite combining a large number of preoperative factors presumed clinically relevant, change in patient-reported outcome 1 year following Meniscal Surgery was not predictable. This essentially quashes the existence of ‘subgroups’ with certain characteristics having a particularly favourable outcome after Meniscal Surgery. Trial registration number NCT01871272.

  • change in patient reported outcomes in patients with and without mechanical symptoms undergoing arthroscopic Meniscal Surgery a prospective cohort study
    Osteoarthritis and Cartilage, 2018
    Co-Authors: Kenneth Pihl, Nis Nissen, Uffe Jørgensen, Martin Englund, Jeppe Schjerning, Aleksandra Turkiewicz, L S Lohmander, Jonas Bloch Thorlund
    Abstract:

    Summary Objective Patients with degenerative or traumatic Meniscal tears are at high risk of developing knee osteoarthritis. We investigated if younger (≤40 years) and older (>40 years) patients with preoperative mechanical symptoms (MS) improved more in patient-reported outcomes after Meniscal Surgery than those without MS. Design Patients from Knee Arthroscopy Cohort Southern Denmark (KACS) undergoing arthroscopic Surgery for a Meniscal tear completed online questionnaires before Surgery, and at 12 and 52 weeks follow-up. Questionnaires included self-reported presence of MS (i.e., sensation of catching and/or locking) and the Knee injury and Osteoarthritis Outcome Score (KOOS). We analyzed between-group differences in change in KOOS4 from baseline to 52 weeks, using an adjusted mixed linear model. Results 150 younger patients (mean age 31 (SD 7), 67% men) and 491 older patients (mean age 54 (SD 9), 53% men) constituted the baseline cohorts. Patients with MS generally had worse self-reported outcomes before Surgery. At 52 weeks follow-up, younger patients with preoperative MS had improved more in KOOS4 scores than younger patients without preoperative MS (adjusted mean difference 10.5, 95% CI: 4.3, 16.6), but did not exceed the absolute postoperative KOOS4 scores observed for those without MS. No difference in improvement was observed between older patients with or without MS (adjusted mean difference 0.7, 95% CI: −2.6, 3.9). Conclusions Younger patients (≤40 years) with preoperative MS experienced greater improvements after arthroscopic Surgery compared to younger patients without MS. Our observational study result needs to be confirmed in randomized trials.

  • 4 change in patient reported outcomes in patients with and without mechanical symptoms undergoing arthroscopic Meniscal Surgery a prospective cohort study
    British Journal of Sports Medicine, 2018
    Co-Authors: Kenneth Pihl, Nis Nissen, Uffe Jørgensen, Martin Englund, Stefan Lohmander, Jeppe Schjerning, Aleksandra Turkiewicz, Jonas Bloch Thorlund
    Abstract:

    Introduction Mechanical symptoms are considered an important indication for Meniscal Surgery. We investigated if young (≤40 years) and older (>40 years) patients, respectively, with preoperative mechanical symptoms improved more in patient-reported outcomes after Meniscal Surgery than those without mechanical symptoms. Materials and methods Patients from Knee Arthroscopy Cohort Southern Denmark (KACS) undergoing arthroscopic Meniscal Surgery between February 2013 and January 2015 completed online questionnaires pre-Surgery, and at 12 and 52 weeks follow-up. Questionnaires included self-reported presence of mechanical symptoms (i.e. sensation of catching and/or locking) and the Knee Injury and Osteoarthritis Outcome Score (KOOS). Between-group differences in change in 4 of 5 KOOS subscales (KOOS4) from baseline to 52 weeks were analysed using an adjusted mixed linear model. Results 150 young patients (mean age 31 (SD 7), 67% men) and 491 older patients (mean age 54 (SD 9), 53% men) constituted the baseline cohorts. In general, patients with mechanical symptoms had worse self-reported outcomes before Surgery. At 52 weeks follow-up, young patients with preoperative mechanical symptoms had improved more in KOOS4 scores than young patients without preoperative mechanical symptoms (adjusted mean difference 10.5, 95% CI: 4.3 to 16.6), but did not exceed their absolute KOOS4 scores. No essential difference in improvement was observed between older patients with or without mechanical symptoms (adjusted mean difference 0.7, 95% CI: −2.6 to 3.9). Conclusion Young patients (≤40 years) with preoperative mechanical symptoms experienced greater improvements after arthroscopic Meniscal Surgery compared to young patients without mechanical symptoms. Randomised controlled trials are needed to confirm this potential subgroup benefit.

  • structural pathology is not related to patient reported pain and function in patients undergoing Meniscal Surgery
    British Journal of Sports Medicine, 2017
    Co-Authors: Simon Maretti Tornbjerg, Nis Nissen, Uffe Jørgensen, Martin Englund, Jeppe Schjerning, Stefan L Lohmander, Jonas Bloch Thorlund
    Abstract:

    Background The relationship between Meniscal tears and other joint pathologies with patient-reported symptoms is not clear. We investigated associations between structural knee pathologies identified at Surgery with preoperative knee pain and function in patients undergoing arthroscopic Meniscal Surgery. Methods This study included 443 patients from the Knee Arthroscopy Cohort Southern Denmark (KACS), a prospective cohort following patients 18 years or older undergoing arthroscopic Meniscal Surgery at 4 hospitals between 1 February 2013 and 31 January 2014. Patient-reported outcomes, including the Knee Injury and Osteoarthritis Outcome Score (KOOS), were obtained by online questionnaires prior to Surgery. Knee pathology was assessed by the operating surgeons using a modified version of the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) classification of Meniscal tears questionnaire, supplemented with information extracted from Surgery reports. Following hypothesis-driven preselection of candidate variables, backward elimination regressions were performed to investigate associations between patient-reported outcomes and structural knee pathologies. Results Regression models only explained a small proportion of the variability in self-reported pain and function (adjusted R2=0.10−0.12) and this association was mainly driven by age, gender and body mass index. Conclusions Specific Meniscal pathology and other structural joint pathologies found at Meniscal Surgery were not associated with preoperative self-reported pain and function in patients with Meniscal tears questioning inferences made about a direct relationship between these. Our findings question the role of arthroscopic Surgery to address structural pathology as a means to improve patient-reported outcomes in patients having Surgery for a Meniscal tear.

Riann M Palmierismith - One of the best experts on this subject based on the ideXlab platform.

  • does concomitant meniscectomy or Meniscal repair affect the recovery of quadriceps function post acl reconstruction
    Knee Surgery Sports Traumatology Arthroscopy, 2015
    Co-Authors: Lindsey K Lepley, Edward M Wojtys, Riann M Palmierismith
    Abstract:

    The purpose of this study was to determine the effect of concomitant Meniscal Surgery on the recovery of quadriceps activation and strength at a time when individuals return to sport following anterior cruciate ligament (ACL) reconstruction. Forty-six individuals that were cleared for participation following ACL reconstruction were invited to participate in this study. Participants were placed into groups according to surgical reports (ACL-only, n = 24; Meniscal repair, n = 12; meniscectomy, n = 10). Quadriceps strength was quantified using isokinetic and isometric measures. Isokinetic strength was collected at 60°/s in concentric mode. Isometric strength was collected at 90° of knee flexion. Quadriceps activation was assessed using the burst superimposition technique and quantified via the central activation ratio. One-way ANOVAs were utilized to detect whether differences existed in quadriceps activation and strength between groups. Where appropriate, post hoc Bonferroni multiple comparison procedures were used. Quadriceps activation (P = n.s.) and strength (isokinetic: P = n.s.; isometric: P = n.s.) were not different between groups. Concomitant meniscectomy or Meniscal repair did not affect the recovery of quadriceps activation and strength at a time when individuals return to sport following ACL reconstruction. Though group differences in quadriceps function were not detected, all participants demonstrated levels of quadriceps activation failure that are below healthy individuals at a time when they were returned to sport. Given that persistent quadriceps activation failure is detrimental to knee function, rehabilitation protocols that target quadriceps activation failure should be developed and employed post-reconstruction. III.

  • does concomitant meniscectomy or Meniscal repair affect the recovery of quadriceps function post acl reconstruction
    Knee Surgery Sports Traumatology Arthroscopy, 2015
    Co-Authors: Lindsey K Lepley, Edward M Wojtys, Riann M Palmierismith
    Abstract:

    Purpose The purpose of this study was to determine the effect of concomitant Meniscal Surgery on the recovery of quadriceps activation and strength at a time when individuals return to sport following anterior cruciate ligament (ACL) reconstruction.

Uffe Jørgensen - One of the best experts on this subject based on the ideXlab platform.

  • wild goose chase no predictable patient subgroups benefit from Meniscal Surgery patient reported outcomes of 641 patients 1 year after Surgery
    British Journal of Sports Medicine, 2020
    Co-Authors: Kenneth Pihl, Nis Nissen, Uffe Jørgensen, Joie Ensor, George Peat, Martin Englund, Stefan Lohmander, Jakob Vium Fristed, Jonas Bloch Thorlund
    Abstract:

    Background Despite absence of evidence of a clinical benefit of arthroscopic partial meniscectomy (APM), many surgeons claim that subgroups of patients benefit from APM. Objective We developed a prognostic model predicting change in patient-reported outcome 1 year following arthroscopic Meniscal Surgery to identify such subgroups. Methods We included 641 patients (age 48.7 years (SD 13), 56% men) undergoing arthroscopic Meniscal Surgery from the Knee Arthroscopy Cohort Southern Denmark. 18 preoperative factors identified from literature and/or orthopaedic surgeons (patient demographics, medical history, symptom onset and duration, knee-related symptoms, etc) were combined in a multivariable linear regression model. The outcome was change in Knee injury and Osteoarthritis Outcome Score (KOOS4) (average score of 4 of 5 KOOS subscales excluding the activities of daily living subscale) from preSurgery to 52 weeks after Surgery. A positive KOOS4 change score constitutes improvement. Prognostic performance was assessed using R2 statistics and calibration plots and was internally validated by adjusting for optimism using 1000 bootstrap samples. Results Patients improved on average 18.6 (SD 19.7, range −38.0 to 87.8) in KOOS4. The strongest prognostic factors for improvement were (1) no previous Meniscal Surgery on index knee and (2) more severe preoperative knee-related symptoms. The model’s overall predictive performance was low (apparent R2=0.162, optimism adjusted R2=0.080) and it showed poor calibration (calibration-in-the-large=0.205, calibration slope=0.772). Conclusion Despite combining a large number of preoperative factors presumed clinically relevant, change in patient-reported outcome 1 year following Meniscal Surgery was not predictable. This essentially quashes the existence of ‘subgroups’ with certain characteristics having a particularly favourable outcome after Meniscal Surgery. Trial registration number NCT01871272.

  • change in patient reported outcomes in patients with and without mechanical symptoms undergoing arthroscopic Meniscal Surgery a prospective cohort study
    Osteoarthritis and Cartilage, 2018
    Co-Authors: Kenneth Pihl, Nis Nissen, Uffe Jørgensen, Martin Englund, Jeppe Schjerning, Aleksandra Turkiewicz, L S Lohmander, Jonas Bloch Thorlund
    Abstract:

    Summary Objective Patients with degenerative or traumatic Meniscal tears are at high risk of developing knee osteoarthritis. We investigated if younger (≤40 years) and older (>40 years) patients with preoperative mechanical symptoms (MS) improved more in patient-reported outcomes after Meniscal Surgery than those without MS. Design Patients from Knee Arthroscopy Cohort Southern Denmark (KACS) undergoing arthroscopic Surgery for a Meniscal tear completed online questionnaires before Surgery, and at 12 and 52 weeks follow-up. Questionnaires included self-reported presence of MS (i.e., sensation of catching and/or locking) and the Knee injury and Osteoarthritis Outcome Score (KOOS). We analyzed between-group differences in change in KOOS4 from baseline to 52 weeks, using an adjusted mixed linear model. Results 150 younger patients (mean age 31 (SD 7), 67% men) and 491 older patients (mean age 54 (SD 9), 53% men) constituted the baseline cohorts. Patients with MS generally had worse self-reported outcomes before Surgery. At 52 weeks follow-up, younger patients with preoperative MS had improved more in KOOS4 scores than younger patients without preoperative MS (adjusted mean difference 10.5, 95% CI: 4.3, 16.6), but did not exceed the absolute postoperative KOOS4 scores observed for those without MS. No difference in improvement was observed between older patients with or without MS (adjusted mean difference 0.7, 95% CI: −2.6, 3.9). Conclusions Younger patients (≤40 years) with preoperative MS experienced greater improvements after arthroscopic Surgery compared to younger patients without MS. Our observational study result needs to be confirmed in randomized trials.

  • 4 change in patient reported outcomes in patients with and without mechanical symptoms undergoing arthroscopic Meniscal Surgery a prospective cohort study
    British Journal of Sports Medicine, 2018
    Co-Authors: Kenneth Pihl, Nis Nissen, Uffe Jørgensen, Martin Englund, Stefan Lohmander, Jeppe Schjerning, Aleksandra Turkiewicz, Jonas Bloch Thorlund
    Abstract:

    Introduction Mechanical symptoms are considered an important indication for Meniscal Surgery. We investigated if young (≤40 years) and older (>40 years) patients, respectively, with preoperative mechanical symptoms improved more in patient-reported outcomes after Meniscal Surgery than those without mechanical symptoms. Materials and methods Patients from Knee Arthroscopy Cohort Southern Denmark (KACS) undergoing arthroscopic Meniscal Surgery between February 2013 and January 2015 completed online questionnaires pre-Surgery, and at 12 and 52 weeks follow-up. Questionnaires included self-reported presence of mechanical symptoms (i.e. sensation of catching and/or locking) and the Knee Injury and Osteoarthritis Outcome Score (KOOS). Between-group differences in change in 4 of 5 KOOS subscales (KOOS4) from baseline to 52 weeks were analysed using an adjusted mixed linear model. Results 150 young patients (mean age 31 (SD 7), 67% men) and 491 older patients (mean age 54 (SD 9), 53% men) constituted the baseline cohorts. In general, patients with mechanical symptoms had worse self-reported outcomes before Surgery. At 52 weeks follow-up, young patients with preoperative mechanical symptoms had improved more in KOOS4 scores than young patients without preoperative mechanical symptoms (adjusted mean difference 10.5, 95% CI: 4.3 to 16.6), but did not exceed their absolute KOOS4 scores. No essential difference in improvement was observed between older patients with or without mechanical symptoms (adjusted mean difference 0.7, 95% CI: −2.6 to 3.9). Conclusion Young patients (≤40 years) with preoperative mechanical symptoms experienced greater improvements after arthroscopic Meniscal Surgery compared to young patients without mechanical symptoms. Randomised controlled trials are needed to confirm this potential subgroup benefit.

  • Patient-reported symptoms and changes up to 1 year after Meniscal Surgery
    2018
    Co-Authors: Søren T Skou, Kenneth Pihl, Nis Nissen, Uffe Jørgensen, Jonas Bloch Thorlund
    Abstract:

    Background and purpose — Detailed information on the symptoms and limitations that patients with Meniscal tears experience is lacking. This study was undertaken to map the most prevalent self-reported symptoms and functional limitations among patients undergoing arthroscopic Meniscal Surgery and investigate which symptoms and limitations had improved most at 1 year after Surgery. Patients and methods — Patients aged 18–76 years from the Knee Arthroscopy Cohort Southern Denmark (KACS) undergoing arthroscopic Meniscal Surgery were included in this analysis of individual subscale items from the Knee Injury and Osteoarthritis Outcome Score and 1 question on knee stability. Severity of each item was scored as none, mild, moderate, severe, or extreme. Improvements were evaluated using Wilcoxon’s signed-rank test and effect size (ES). Results — The most common symptoms were knee grinding and clicking, knee pain in general, pain when twisting and bending the knee and climbing stairs (88–98%), while the most common functional limitations were difficulty bending to the floor, squatting, twisting, kneeling, and knee awareness (97–99%). Knee pain in general and knee awareness improved most 1 year after Meniscal Surgery (ES –0.47 and –0.45; p < 0.001), while knee instability and general knee difficulties improved least (ES 0.10 and –0.08; p < 0.006). Interpretation — Adults undergoing Surgery for a Meniscal tear commonly report clinical symptoms and functional limitations related to their daily activities. Moderate improvements were observed in some symptoms and functional limitations and small to no improvement in others at 1 year after Surgery. These findings can assist the clinical discussion of symptoms, treatments, and patients’ expectations.

  • Patient-reported symptoms and changes up to 1 year after Meniscal Surgery: An observational cohort study of 641 adult patients with a Meniscal tear
    Taylor & Francis Group, 2018
    Co-Authors: Søren T Skou, Kenneth Pihl, Nis Nissen, Uffe Jørgensen, Jonas Bloch Thorlund
    Abstract:

    Background and purpose — Detailed information on the symptoms and limitations that patients with Meniscal tears experience is lacking. This study was undertaken to map the most prevalent self-reported symptoms and functional limitations among patients undergoing arthroscopic Meniscal Surgery and investigate which symptoms and limitations had improved most at 1 year after Surgery. Patients and methods — Patients aged 18–76 years from the Knee Arthroscopy Cohort Southern Denmark (KACS) undergoing arthroscopic Meniscal Surgery were included in this analysis of individual subscale items from the Knee Injury and Osteoarthritis Outcome Score and 1 question on knee stability. Severity of each item was scored as none, mild, moderate, severe, or extreme. Improvements were evaluated using Wilcoxon’s signed-rank test and effect size (ES). Results — The most common symptoms were knee grinding and clicking, knee pain in general, pain when twisting and bending the knee and climbing stairs (88–98%), while the most common functional limitations were difficulty bending to the floor, squatting, twisting, kneeling, and knee awareness (97–99%). Knee pain in general and knee awareness improved most 1 year after Meniscal Surgery (ES –0.47 and –0.45; p < 0.001), while knee instability and general knee difficulties improved least (ES 0.10 and –0.08; p < 0.006). Interpretation — Adults undergoing Surgery for a Meniscal tear commonly report clinical symptoms and functional limitations related to their daily activities. Moderate improvements were observed in some symptoms and functional limitations and small to no improvement in others at 1 year after Surgery. These findings can assist the clinical discussion of symptoms, treatments, and patients’ expectations

Olufemi R Ayeni - One of the best experts on this subject based on the ideXlab platform.

  • correction to anterior cruciate ligament reconstruction with concomitant Meniscal Surgery a systematic review and meta analysis of outcomes
    Knee Surgery Sports Traumatology Arthroscopy, 2019
    Co-Authors: Mohamed Sarraj, Ryan P Coughlin, Max Solow, Seper Ekhtiari, Nicole Simunovic, Aaron J Krych, Peter B Macdonald, Olufemi R Ayeni
    Abstract:

    Unfortunately, the middle name of Olufemi R. Ayeni was accidentally omitted in the original publication and the author name is corrected here. The original article has been corrected.

  • anterior cruciate ligament reconstruction with concomitant Meniscal Surgery a systematic review and meta analysis of outcomes
    Knee Surgery Sports Traumatology Arthroscopy, 2019
    Co-Authors: Mohamed Sarraj, Ryan P Coughlin, Max Solow, Seper Ekhtiari, Nicole Simunovic, Aaron J Krych, Peter B Macdonald, Olufemi R Ayeni
    Abstract:

    The aim of this review was to compare the clinical outcomes of anterior cruciate ligament reconstruction (ACLR) with either Meniscal repair or meniscectomy for concomitant Meniscal injury. The primary hypothesis was that short-term clinical outcomes (≤ 2-year follow-up) for ACLR concomitant with either Meniscal repair or resection would be similar. The secondary hypothesis was that ACLR with Meniscal repair would result in better longer term outcomes compared with Meniscal resection. The authors searched two online databases (EMBASE and MEDLINE) from inception until March 2018 for the literature on ACLR and concurrent Meniscal Surgery. Two reviewers systematically screened studies in duplicate, independently, and based on a priori criteria. Quality assessment was also performed in duplicate. The Knee injury and Osteoarthritis Outcome Score (KOOS) sub-scale scores at 2 years post-operatively were combined in a meta-analysis of proportions using a random-effects model. Of 2566 initial studies, 25 studies satisfied full-text inclusion criteria. Mean follow-up was 2.09 years, with a total sample of 37,087 subjects including controls. The meta-analysis demonstrated equivocal results at 2 years, except for KOOS symptom scores which favoured Meniscal resection over repair. Mean KT-1000 side-to-side difference (SSD) scores were 1.51 ± 0.60 mm for Meniscal repair, 1.96 ± 0.36 mm for Meniscal resection, and 1.58 ± 0.20 for control patients (isolated ACLR). Medial Meniscal repair showed decreased anterior knee joint laxity compared to medial Meniscal resection (P < 0.001). Patients with Meniscal repair had higher rates of re-operation (13.3% vs 0.8% for Meniscal resection, P < 0.001). Patients with ACLR combined with Meniscal resection demonstrate better symptoms at 2-year follow-up compared to patients with ACLR combined with Meniscal repair. ACLR combined with Meniscal repair results in decreased anterior knee joint laxity with evidence of improved patient-reported outcomes in the long term, but also higher re-operation rates. III.