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Patient-reported outcomes of meniscal repair and meniscectomy in patients 40 years of age and older show similar good results

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

The purpose of this study is to evaluate patient-reported outcome measures (PROMs) in patients aged 40 years and older who underwent meniscal repair or meniscectomy. All patients aged 40 and older who underwent a meniscal repair at a single institution from 2006 to 2017 were included. Meniscal repair cases were matched with a meniscectomy control group in a 1:3 ratio, selected for an equal proportion of concomitant ACL reconstruction in each group. PROMs, collected at a minimum follow-up of 24 months, included International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC), Marx activity scale, and a patient satisfaction scale. The primary outcome was IKDC score, which was compared between groups using a Mann–Whitney U test. Rate of failure, defined as repeat ipsilateral knee surgery or surgeon report of failure, was reported. Thirty-five meniscal repair patients and 131 meniscectomy patients were identified; 28 (80.0%) and 67 (51.1%) completed all PROMs with mean follow-up of 4.9 and 5.2 years, respectively. The mean age was 48.5 ± 7.0 years in the meniscal repair cohort and 52.8 ± 7.1 years in the meniscectomy cohort (p = 0.009). Concomitant ACL reconstruction was present in 46.4% and 49.3% of the meniscal repair and meniscectomy cohorts, respectively (n.s.). The median IKDC score was 78 (IQR 66, 87) in the repair cohort and 77 (IQR 56, 86) in the meniscectomy cohort (n.s.). The median Marx activity scale was 3.5 (IQR 0, 8) in the repair cohort and 3.0 (IQR 0, 9) in the meniscectomy cohort (n.s.). Over 85% of both groups were satisfied or very satisfied with no between-group differences (n.s.). In patients aged 40 years and older, patient-reported outcomes at an average of 5 years postoperatively were satisfactory and similar in patients undergoing meniscal repair and meniscectomy, indicating that age alone should not be a contraindication to meniscal repair.

Level of evidence: Level III.

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Acknowledgements

We would like to acknowledge Dr. Brian McKeon, Dr. Paul Weitzel, and Dr. Suzanne Miller for contributing patients and data to this study as well as Samuel Golenbock at New England Baptist Hospital for statistical analysis.

Funding

There were no internal or external sources of funding for this project.

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Authors and Affiliations

  1. Department of Orthopaedics, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA

    Ian D. Engler & Matthew J. Salzler

  2. Tufts University School of Medicine, 145 Harrison Ave, Boston, MA, 02111, USA

    Julia R. Moradian & Benjamin M. Pockros

  3. Tufts University, 419 Boston Ave, Medford, MA, 02155, USA

    Carl M. Schirmeister

  4. New England Baptist Hospital, 125 Parker Hill Ave, Boston, MA, 02120, USA

    John C. Richmond

  5. Boston Sports and Shoulder Center, 40 Allied Drive, Suite 102, Dedham, MA, 02026, USA

    John C. Richmond

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  1. Ian D. Engler
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  4. Carl M. Schirmeister
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  6. Matthew J. Salzler
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Contributions

MS, IE, and JM contributed to study design, with JR providing oversight. JR provided access to patient data and resources. JM, BP, and CS were involved in data collection. IE, JM, BP, and MS were primary writers of the manuscripts. All authors agreed upon the final manuscript.

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Correspondence to Ian D. Engler.

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IRB approval at New England Baptist Hospital, IRB number 1174106-1.

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Engler, I.D., Moradian, J.R., Pockros, B.M. et al. Patient-reported outcomes of meniscal repair and meniscectomy in patients 40 years of age and older show similar good results. Knee Surg Sports Traumatol Arthrosc 29, 2911–2917 (2021). https://doi.org/10.1007/s00167-020-06299-5

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