Two-year MRI-defined structural damage and patient-reported outcomes following surgery or exercise for meniscal tears in young adults

Stine Haugaard Clausen*, Søren T. Skou, Mikael Ploug Boesen, Dimitar Ivanon Radev, Engin Yeter Kurt, Camma Damsted, Per Hölmich, Martin Lind, Sofus Tørring, Christin Isaksen, Claus Varnum, Martin Englund, Jonas Bloch Thorlund

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

2 Citations (Scopus)
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Abstract

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 (KOOS4) 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 KOOS4 between intervention groups from baseline to 2 years was −1.4 (−9.1, 6.2) points. The mean improvement in KOOS4 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 KOOS4, suggesting the choice of treatment strategy does not impact 2-year structural knee damage or PROMs.

Original languageEnglish
JournalBritish Journal of Sports Medicine
Volume57
Issue number24
Pages (from-to)1566-1572
Number of pages7
ISSN0306-3674
DOIs
Publication statusPublished - 2023

Bibliographical note

Funding Information:
STS has received personal fees from Munksgaard, TrustMe-Ed and Nestlé Health Science, outside the submitted work, and is cofounder of Good Life with osteoArthritis in Denmark (GLA:D), a not-for-profit initiative hosted at University of Southern Denmark aimed at implementing clinical guidelines for osteoarthritis in clinical practice. JBT reports a research grant from Pfizer outside the submitted work (completed in 2022). CV reports no conflict of interest in this study. Outside submitted work CV received travel expenses from Stryker. Other authors: no conflict of interest.

Funding Information:
The study was funded by the Danish Council for Independent Research (DFF-6110-00045 and Sapere Aude Research Talent Award DFF-6110-00045B). The DREAM study was funded IMK Almene Fond, Lundbeck Foundation, Spar Nord Foundation, Danish Rheumatism Association, Association of Danish Physiotherapists Research Fund, Research Council at Næstved-Slagelse-Ringsted Hospitals and Region Zealand (Exercise First program grant). The funders had no role in study design, data collection, data analysis, data interpretation or writing of the report.

Publisher Copyright:
© Author(s) (or their employer(s)) 2023. No.

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