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Original article
Conundrum of mechanical knee symptoms: signifying feature of a meniscal tear?
  1. Jonas Bloch Thorlund1,
  2. Kenneth Pihl1,
  3. Nis Nissen2,
  4. Uffe Jørgensen3,
  5. Jakob Vium Fristed4,
  6. L Stefan Lohmander5,
  7. Martin Englund6,7
  1. 1 Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
  2. 2 Department of Orthopaedics, Lillebaelt Hospital, Kolding, Denmark
  3. 3 Department of Orthopedics and Traumatology, Odense University Hospital, Odense, Denmark
  4. 4 Department of Orthopaedics, Lillebaelt Hospital, Vejle, Denmark
  5. 5 Department of Clinical Sciences Lund, Orthopaedics, Faculty of Medicine, Lund University, Lund, Sweden
  6. 6 Clinical Epidemiology Unit, Department of Clinical Sciences Lund, Orthopaedics, Faculty of Medicine, Lund University, Lund, Sweden
  7. 7 Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Massachusetts, USA
  1. Correspondence to Dr. Jonas Bloch Thorlund, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense 5230, Denmark; jthorlund{at}health.sdu.dk

Abstract

Background Mechanical knee symptoms are often considered important in the decision to perform knee arthroscopy on the suspicion of a meniscal tear. We investigated if presence of a meniscal tear at knee arthroscopy in adults is associated with presence of preoperative self-reported mechanical knee symptoms.

Methods We used data from Knee Arthroscopy Cohort Southern Denmark (KACS). KACS consists of patients aged 18 years or older referred to knee arthroscopy on the suspicion of a meniscal tear at four recruiting hospitals between 1 February 2013 and 31 January 2015. Of 1259 invited patients, 908 (72%) replied to the baseline questionnaire. With 91 patients excluded, the study sample consisted of 641 and 176 patients with and without a meniscal tear confirmed at surgery, respectively. Exposure was meniscal tear as determined by the knee surgeon during arthroscopy. Main outcomes were preoperative mechanical knee symptoms defined as self-reported catching/locking or self-reported inability to straighten knee fully.

Results 55% of all patients reported symptoms of catching/locking and 47% were unable to straighten their knee fully. Preoperative mechanical symptoms were equally prevalent in patients with and without a meniscal tear (prevalence ratio catching/locking 0.89, 95% CI 0.77 to 1.03, and inability to straighten knee fully, prevalence ratio 1.02, 95% CI 0.84 to 1.23).

Interpretation Patient-reported mechanical symptoms were equally common irrespective of presence or absence of a meniscal tear in patients undergoing arthroscopy for suspicion of a meniscal tear. Our findings suggest that mechanical knee symptoms have a limited value when considering indication for meniscal surgery.

Trial registration number NCT01871272; Results.

  • knee
  • osteoarthritis
  • meniscal pathology
  • arthroscopy
  • epidemiology

https://doi.org/10.1136/bjsports-2018-099431

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    Footnotes

    • Contributors Concept and design: JBT, KP, LSL, ME. Acquisition, analysis and interpretation of data: JBT, KP, NN, UJ, JVF, LSL, ME. Drafting of the manuscript: JBT, ME. Critical revision of the manuscript for important intellectual content: KP, NN, UJ, JVF, LSL. Approval of final submitted version of manuscript: all authors.

    • Funding This study was supported by an individual postdoctoral grant (JBT) from the Danish Council for Independent Research | Medical Sciences and funds from the Region of Southern Denmark.

    • Competing interests ME reports grants from the Swedish Research Council, grants from Österlund Foundation, grants from Governmental Funding of Clinical Research within National Health Service (ALF), during the conduct of the study.

    • Patient consent Obtained.

    • Ethics approval The Regional Scientific Ethics Committee of Southern Denmark waived the need for ethical approval after reviewing the outline of KACS.14

    • Provenance and peer review Not commissioned; externally peer reviewed.