@article{a5077cb2ec114c93b6bbaf25e089be06,
title = "Association Between Baseline Meniscal Symptoms and Outcomes of Operative and Nonoperative Treatment of Meniscal Tear in Patients With Osteoarthritis",
abstract = "Objective: Patients with meniscal tears reporting meniscal symptoms such as catching or locking have traditionally undergone arthroscopy. The present study was undertaken to investigate whether patients with meniscal tears who report meniscal symptoms have greater improvement with arthroscopic partial meniscectomy (APM) than physical therapy (PT). Methods: We used data from the Meniscal Tear in Osteoarthritis Research (MeTeOR) trial, which randomized participants with knee osteoarthritis (OA) and meniscal tear to APM or PT. The frequency of each meniscal symptom (clicking, catching, popping, intermittent locking, giving way, swelling) was measured at baseline and 6 months. We used linear regression models to determine whether the difference in improvement in Knee Injury and Osteoarthritis Outcome Score (KOOS) pain score at 6 months between patients treated with APM versus PT was modified by the presence of each meniscal symptom. We also determined the percentage of participants with resolution of meniscal symptoms by treatment group. Results: We included 287 participants. The presence (versus absence) of any of the meniscal symptoms did not modify the improvement in KOOS pain score between APM versus PT by >0.5 SD (all P interaction >0.05). APM led to greater resolution of intermittent locking and clicking than PT (locking 70% versus 46%, clicking 41% versus 25%). No difference in resolution of the other meniscal symptoms was observed. Conclusion: Meniscal symptoms were not associated with improved pain relief. Although symptoms of clicking and intermittent locking had a greater reduction in the APM group, the presence of meniscal symptoms in isolation should not inform clinical decisions surrounding APM versus PT in patients with meniscal tear and knee OA.",
author = "MacFarlane, {Lindsey A.} and Heidi Yang and Collins, {Jamie E.} and Brophy, {Robert H.} and Cole, {Brian J.} and Spindler, {Kurt P.} and Ali Guermazi and Jones, {Morgan H.} and Mandl, {Lisa A.} and Scott Martin and Marx, {Robert G.} and Levy, {Bruce A.} and Michael Stuart and Clare Safran-Norton and John Wright and Wright, {Rick W.} and Elena Losina and Katz, {Jeffrey N.}",
note = "Funding Information: Dr. MacFarlane has received research support from Samumed. Dr. Collins has received consulting fees from Boston Imaging Core Lab (less than $10,000). Dr. Cole has received consulting fees, speaking fees, and/or honoraria from Aesculap, Smith and Nephew, Bandgrip, Acumed, Encore Medical, GE Healthcare, Merck Sharp & Dohme, SportsTek Medical, Vericel Corporation, Elsevier, Ossio, Regentis (less than $10,000 each), and Arthrex (more than $10,000). Dr. Spindler has received consulting fees from Mitek, Flexion Therapeutics, Samumed, and Novopeds (less than $10,000 each). Dr. Guermazi has received consulting fees, speaking fees, and/or honoraria from Boston Imaging Core Lab, AstraZeneca, Roche, Galapagos (less than $10,000 each), TissueGene, Pfizer, and MerckSerono (more than $10,000 each). Dr. Jones has received consulting fees, speaking fees, and/or honoraria from Samumed and Regeneron (less than $10,000 each) and research support from Flexion Therapeutics. Dr. Mandl has received royalties from UpToDate and research support from Regeneron. Dr. Marx has received consulting fees, speaking fees, and/or honoraria from Mend Nutrition (less than $10,000) and royalties from Springer and Demos Health. Dr. Levy has received consulting fees from Arthrex and Smith and Nephew (less than $10,000 each). Dr. Stuart has received consulting fees and royalties from Arthrex (more than $10,000) and research support from Arthrex and Stryker. Dr. Safran‐Norton owns stock or stock options in Merck and Johnson & Johnson. Dr. J. Wright owns stock or stock options in Johnson & Johnson. Dr. R. Wright has received consulting fees and royalties from Responsive Arthroscopy (less than $10,000). Dr. Losina has received consulting fees from Pfizer (less than $10,000) and research support from Flexion Therapeutics, Samumed, and Pfizer. Dr. Katz has received research support from Flexion Therapeutics, Samumed, and Pfizer. No other disclosures relevant to this article were reported. Funding Information: Supported by the NIH (National Institute of Arthritis and Musculoskeletal and Skin Diseases grants R01‐AR‐05557, T32‐AR‐055885, K24‐AR‐057827, and P30‐AR‐072577) and the Rheumatology Research Foundation (Scientific Development award). Publisher Copyright: {\textcopyright} 2021 American College of Rheumatology.",
year = "2022",
month = aug,
doi = "10.1002/acr.24588",
language = "English (US)",
volume = "74",
pages = "1384--1390",
journal = "Arthritis Care and Research",
issn = "2151-464X",
number = "8",
}