TY - JOUR
T1 - Two-year MRI-defined structural damage and patient-reported outcomes following surgery or exercise for meniscal tears in young adults
AU - Clausen, Stine Haugaard
AU - Skou, Søren T.
AU - Boesen, Mikael Ploug
AU - Radev, Dimitar Ivanov
AU - Kurt, Engin Yeter
AU - Damsted, Camma
AU - Hölmich, Per
AU - Lind, Martin
AU - Tørring, Sofus
AU - Isaksen, Christin
AU - Varnum, Claus
AU - Englund, Martin
AU - Thorlund, Jonas Bloch
N1 - © Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2023/12
Y1 - 2023/12
N2 - Objective To investigate potential differences in structural knee joint damage assessed by MRI and patient-reported outcomes (PROMs) at 2-year follow-up between young adults randomised to early surgery or exercise and education with optional delayed surgery for a meniscal tear. Methods A secondary analysis of a multicentre randomised controlled trial including 121 patients (18–40 years) with an MRI-verified meniscal tear. For this study, only patients with 2-year follow-up were included. The main outcomes were the difference in worsening of structural knee damage, assessed by MRI using the Anterior Cruciate Ligament OsteoArthrits Score, and the difference in change in the mean score of four Knee Injury and Osteoarthritis Outcome Score (KOOS
4) subscales covering pain, symptoms, function in sport and recreation, and quality of life, from baseline to 2 years. Results In total, 82/121 (68%) patients completed the 2-year follow-up (39 from the surgical group and 43 from the exercise group). MRI-defined cartilage damage had developed or progressed in seven (9.1%) patients and osteophytes developed in two (2.6%) patients. The worsening of structural damage from baseline to 2-year follow-up was similar between groups. The mean (95% CI) adjusted differences in change in KOOS
4 between intervention groups from baseline to 2 years was −1.4 (−9.1, 6.2) points. The mean improvement in KOOS
4 was 16.4 (10.4, 22.4) in the surgical group and 21.5 (15.0, 28.0) in the exercise group. No between group differences in improvement were found in the KOOS subscales. Conclusions The 2-year worsening of MRI-defined structural damage was limited and similar in young adult patients with a meniscal tear treated with surgery or exercise with optional delayed surgery. Both groups had similar clinically relevant improvements in KOOS
4, suggesting the choice of treatment strategy does not impact 2-year structural knee damage or PROMs.
AB - Objective To investigate potential differences in structural knee joint damage assessed by MRI and patient-reported outcomes (PROMs) at 2-year follow-up between young adults randomised to early surgery or exercise and education with optional delayed surgery for a meniscal tear. Methods A secondary analysis of a multicentre randomised controlled trial including 121 patients (18–40 years) with an MRI-verified meniscal tear. For this study, only patients with 2-year follow-up were included. The main outcomes were the difference in worsening of structural knee damage, assessed by MRI using the Anterior Cruciate Ligament OsteoArthrits Score, and the difference in change in the mean score of four Knee Injury and Osteoarthritis Outcome Score (KOOS
4) subscales covering pain, symptoms, function in sport and recreation, and quality of life, from baseline to 2 years. Results In total, 82/121 (68%) patients completed the 2-year follow-up (39 from the surgical group and 43 from the exercise group). MRI-defined cartilage damage had developed or progressed in seven (9.1%) patients and osteophytes developed in two (2.6%) patients. The worsening of structural damage from baseline to 2-year follow-up was similar between groups. The mean (95% CI) adjusted differences in change in KOOS
4 between intervention groups from baseline to 2 years was −1.4 (−9.1, 6.2) points. The mean improvement in KOOS
4 was 16.4 (10.4, 22.4) in the surgical group and 21.5 (15.0, 28.0) in the exercise group. No between group differences in improvement were found in the KOOS subscales. Conclusions The 2-year worsening of MRI-defined structural damage was limited and similar in young adult patients with a meniscal tear treated with surgery or exercise with optional delayed surgery. Both groups had similar clinically relevant improvements in KOOS
4, suggesting the choice of treatment strategy does not impact 2-year structural knee damage or PROMs.
KW - Arthroscopy
KW - Exercise Therapy
KW - Meniscus
KW - Osteoarthritis
UR - http://www.scopus.com/inward/record.url?scp=85175850914&partnerID=8YFLogxK
U2 - 10.1136/bjsports-2023-107352
DO - 10.1136/bjsports-2023-107352
M3 - Journal article
C2 - 37879858
SN - 0306-3674
VL - 57
SP - 1566
EP - 1572
JO - British Journal of Sports Medicine
JF - British Journal of Sports Medicine
IS - 24
M1 - bjsports-2023-107352
ER -