New work performed at The Ohio State University Wexner Medical Center in Columbus has found some interesting associations when it comes to activity level and the success (or lack thereof) of meniscal repair.
The study, “Meniscus repair five-year results are influenced by patient pre-injury activity level but not age group,” is published in the December 2, 2019 edition of The Knee.
Co-author David C. Flanigan, M.D., an orthopedic surgeon at Wexner Medical Center explained to OTW why he and his team decided to tackle this subject, “We wanted to look at the effect of age on meniscus repairs, and if activity level was a significant driver in the results after meniscus repair.”
Flanigan and his team then collected data for 225 patients (11% of whom were sedentary, 63% recreational athletes, 26% competitive athletes; 72% cutting-pivoting sports and 28% of whom participated in non-cutting or non-pivoting sports) who were treated with meniscal repair. The team then assessed each patient for symptomatic failure and asked to participate in a subjective knee function survey (Knee Osteoarthritis Outcome Score, KOOS, and International Knee Documentation Committee Subjective, IKDC-S, scores. On average, the research team was able to collect 5.4 years of follow-up data.
Flanigan and the team found that 20% of the patients experienced repair failure overall with no association with any particular age group (<40 vs. ≥40 years) or level of activity.
When the research team looked at the IKDC-S scores for sedentary patients, they found that changes in the scores were not associated with a particular age group but were lower among sedentary patients as compared with recreational or competitive athletes. The KOOS-ADL scores were independently associated with age and were higher among patients who were older than 40 years. The team did not find any age associated differences with regards to KOOS-pain, KOOS-sport, or KOOS-QOL scores. Finally, the team found that sedentary status was independently associated with lower KOOS scores for all sub-scores.
Dr. Flanigan provided more insight into this interesting lack of age associations to OTW, “Age doesn’t impact the results of meniscus repairs. More active patients, regardless of age, have better results. this may be due to increased internal drive and motivation to return to activity. Sedentary patients, regardless of age have poorer patient reported outcomes.”
“Meniscus repair is successful regardless of age. Age should not be a limiting factor for surgeons to consider meniscus repair. Sedentary patients may not get as much improvement and may need counseling that they may have some persistent symptoms or discomfort.”
