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Predictive Factors and Duration to Return to Sport After Isolated Meniscectomy

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 meniscect...

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Autores principales: Agarwalla, Avinesh, Gowd, Anirudh K., Liu, Joseph N., Lalehzarian, Simon P., Christian, David R., Cole, Brian J., Forsythe, Brian, Verma, Nikhil N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6484247/
https://www.ncbi.nlm.nih.gov/pubmed/31041328
http://dx.doi.org/10.1177/2325967119837940
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author Agarwalla, Avinesh
Gowd, Anirudh K.
Liu, Joseph N.
Lalehzarian, Simon P.
Christian, David R.
Cole, Brian J.
Forsythe, Brian
Verma, Nikhil N.
author_facet Agarwalla, Avinesh
Gowd, Anirudh K.
Liu, Joseph N.
Lalehzarian, Simon P.
Christian, David R.
Cole, Brian J.
Forsythe, Brian
Verma, Nikhil N.
author_sort Agarwalla, Avinesh
collection PubMed
description 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.
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spelling pubmed-64842472019-04-30 Predictive Factors and Duration to Return to Sport After Isolated Meniscectomy Agarwalla, Avinesh Gowd, Anirudh K. Liu, Joseph N. Lalehzarian, Simon P. Christian, David R. Cole, Brian J. Forsythe, Brian Verma, Nikhil N. Orthop J Sports Med Article 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. SAGE Publications 2019-04-25 /pmc/articles/PMC6484247/ /pubmed/31041328 http://dx.doi.org/10.1177/2325967119837940 Text en © The Author(s) 2019 http://creativecommons.org/licenses/by-nc-nd/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (http://www.creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Article
Agarwalla, Avinesh
Gowd, Anirudh K.
Liu, Joseph N.
Lalehzarian, Simon P.
Christian, David R.
Cole, Brian J.
Forsythe, Brian
Verma, Nikhil N.
Predictive Factors and Duration to Return to Sport After Isolated Meniscectomy
title Predictive Factors and Duration to Return to Sport After Isolated Meniscectomy
title_full Predictive Factors and Duration to Return to Sport After Isolated Meniscectomy
title_fullStr Predictive Factors and Duration to Return to Sport After Isolated Meniscectomy
title_full_unstemmed Predictive Factors and Duration to Return to Sport After Isolated Meniscectomy
title_short Predictive Factors and Duration to Return to Sport After Isolated Meniscectomy
title_sort predictive factors and duration to return to sport after isolated meniscectomy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6484247/
https://www.ncbi.nlm.nih.gov/pubmed/31041328
http://dx.doi.org/10.1177/2325967119837940
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