PMID- 33364610
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2666-061X (Electronic)
IS  - 2666-061X (Linking)
VI  - 2
IP  - 6
DP  - 2020 Dec
TI  - Time to Achievement of Clinically Significant Outcomes After Isolated 
      Arthroscopic Partial Meniscectomy: A Multivariate Analysis.
PG  - e723-e733
LID - 10.1016/j.asmr.2020.06.002 [doi]
AB  - PURPOSE: To define the time required to achieve the minimally clinically 
      important difference (MCID), substantial clinical benefit (SCB) and patient 
      acceptable symptomatic state (PASS) for isolated arthroscopic partial 
      meniscectomy (APM), and define preoperative and intraoperative factors that 
      predict both early and late achievement of the stated metrics. METHODS: Patients 
      who underwent isolated APM between 2014 and 2017 were retrospectively included. 
      Patients without preoperative and 6-month patient-reported outcome measure 
      scores, revision procedures, and significant concomitant procedures were 
      excluded. The MCID, SCB, and PASS were calculated for knee-based patient-reported 
      outcome measure scores using receiver operating curve analysis. Kaplan-Meier 
      survival analysis established the time required to achieve MCID, SCB and PASS. 
      Hazard ratios from multivariate Cox regression allowed for the isolation of 
      demographic and intraoperative factors predictive of the delayed time required to 
      achieve MCID, SCB and PASS. RESULTS: A total of 126 patients (42.86% female, age: 
      48.9 +/- 12.4 years) were included. Overall achievement rates ranged between 73.0% 
      and 89.7% for MCID, 43.7% and 68.2% for SCB, and 50.8% and 68.3% for PASS. Median 
      achievement time for MCID was 5.68-5.78 months, 5.73-6.05 months for SCB and 
      6.54-7.72 months for PASS. Multivariate Cox regression identified older age, 
      workers' compensation status, diabetes, and various tear types (i.e., 
      longitudinal, transverse, bucket handle, complex) as predictors of early 
      clinically significant outcome achievement (hazard ratio: 1.02-24.72), whereas 
      subsequent steroid injection, higher preoperative scores and root and flap tears 
      predicted delays in clinically significant outcome achievement (hazard ratio: 
      0.12-0.99). CONCLUSIONS: The majority of patients undergoing APM achieve benefit 
      within 6 months of surgery, with diminishing proportions at later timepoints. 
      Important factors for consideration of the the timeline of achieving clinically 
      significant outcome include age, diabetes, workers' compensation, preoperative 
      score, and tear type. The timeline for achieving improvement that was established 
      by this study may aid in setting patient expectations and designing future 
      outcome studies involving APM. STUDY DESIGN: Level IV, Therapeutic Case Series.
CI  - (c) 2020 by the Arthroscopy Association of North America. Published by Elsevier 
      Inc.
FAU - Beletsky, Alexander
AU  - Beletsky A
AD  - Department of Orthopedic Surgery, Midwest Orthopaedics at Rush, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Gowd, Anirudh K
AU  - Gowd AK
AD  - Department of Orthopedic Surgery, Midwest Orthopaedics at Rush, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Liu, Joseph N
AU  - Liu JN
AD  - Department of Orthopedic Surgery, Loma Linda Medical Center, Loma Linda, 
      California, U.S.A.
FAU - Manderle, Brandon J
AU  - Manderle BJ
AD  - Department of Orthopedic Surgery, Midwest Orthopaedics at Rush, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Yanke, Adam B
AU  - Yanke AB
AD  - Department of Orthopedic Surgery, Midwest Orthopaedics at Rush, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Forsythe, Brian
AU  - Forsythe B
AD  - Department of Orthopedic Surgery, Midwest Orthopaedics at Rush, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Cole, Brian J
AU  - Cole BJ
AD  - Department of Orthopedic Surgery, Midwest Orthopaedics at Rush, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Verma, Nikhil
AU  - Verma N
AD  - Department of Orthopedic Surgery, Midwest Orthopaedics at Rush, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
LA  - eng
PT  - Journal Article
DEP - 20201215
PL  - United States
TA  - Arthrosc Sports Med Rehabil
JT  - Arthroscopy, sports medicine, and rehabilitation
JID - 101765256
PMC - PMC7754524
EDAT- 2020/12/29 06:00
MHDA- 2020/12/29 06:01
PMCR- 2020/12/15
CRDT- 2020/12/28 12:03
PHST- 2019/05/23 00:00 [received]
PHST- 2020/06/04 00:00 [accepted]
PHST- 2020/12/28 12:03 [entrez]
PHST- 2020/12/29 06:00 [pubmed]
PHST- 2020/12/29 06:01 [medline]
PHST- 2020/12/15 00:00 [pmc-release]
AID - S2666-061X(20)30067-5 [pii]
AID - 10.1016/j.asmr.2020.06.002 [doi]
PST - epublish
SO  - Arthrosc Sports Med Rehabil. 2020 Dec 15;2(6):e723-e733. doi: 
      10.1016/j.asmr.2020.06.002. eCollection 2020 Dec.