PMID- 37116548 OWN - NLM STAT- Publisher LR - 20231022 IS - 1526-3231 (Electronic) IS - 0749-8063 (Linking) VI - 39 IP - 11 DP - 2023 Nov TI - Patient-Specific Variables Associated with Failure to Achieve Clinically Significant Outcomes After Meniscal Allograft Transplantation at Minimum 5 Year Follow-Up. PG - 2327-2338 LID - S0749-8063(23)00307-9 [pii] LID - 10.1016/j.arthro.2023.03.031 [doi] AB - PURPOSE: To determine the improvements in patient-reported outcome measures (PROMs) necessary to achieve minimal clinically important difference (MCID), patient-acceptable symptomatic state (PASS), and substantial clinical benefit (SCB) after primary meniscal allograft transplantation (MAT) at a minimum of 5-year follow-up, while identifying variables predictive of achieving clinically significant outcomes (CSOs). METHODS: A retrospective review was performed to identify patients undergoing primary MAT at a single institution from 1999 to 2016. Lysholm, International Knee Documentation Committee (IKDC), and Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales were collected before surgery and at a minimum of 5-year follow-up. A distribution-based approach was used to calculate MCID, whereas an anchor-based approach was used to calculate SCB and PASS. Multivariate logistic regression was performed to determine factors associated with CSO achievement. RESULTS: A total of 202 patients undergoing MAT (56% medial, 44% lateral) were included with a mean follow-up of 9.8 +/- 4.1 years, age of 29.7 +/- 8.5 years, and body mass index (BMI) of 26.5 +/- 4.7. Thresholds for achieving MCID, PASS, and SCB, respectively, at a minimum 5-year follow-up for Lysholm (10.3, 74.5, 32.5), IKDC (12.1, 55.6, 29.1), and KOOS subscales questionnaires (Pain [11.0, 70.7, 25.1], Symptoms [11.0, 60.8, 19.6], Activities of Daily Living [10.5, 90.3, 17.9], Sport [16.2, 47.4, 37.5], and Quality of Life [13.6, 40.5, 37.3]) were calculated. Reduced odds of achieving MCID were associated with higher preoperative PROM scores, BMI, patient age, concomitant osteotomy, male sex, and worker's compensation (WC) status. Reduced odds of achieving PASS were associated with lower preoperative PROM scores, higher BMI (particularly >/=30), patient age, and WC status. Reduced odds of achieving SCB were associated with higher preoperative PROM scores and WC status. CONCLUSIONS: This study established the MCID, PASS, and SCB at 5-year minimum follow-up for the Lysholm score, IKDC, and KOOS subscales in patients who underwent MAT. Increased BMI and patient age, male sex, performance of concomitant osteotomy, WC status, and preoperative PROM scores were associated with failure to achieve CSOs after primary MAT at a minimum of 5-year follow-up. LEVEL OF EVIDENCE: Level IV, therapeutic study, retrospective case series. CI - Copyright (c) 2023 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved. FAU - Wagner, Kyle R AU - Wagner KR AD - Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois. FAU - Kaiser, Joshua T AU - Kaiser JT AD - Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois. FAU - Knapik, Derrick M AU - Knapik DM AD - Washington University School of Medicine, St. Louis, Missouri. FAU - Condron, Nolan B AU - Condron NB AD - University of Massachusetts Chan Medical School, Worcester, Massachusetts, U.S.A. FAU - Gilat, Ron AU - Gilat R AD - Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois. FAU - Meeker, Zach D AU - Meeker ZD AD - Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois. FAU - Sivasundaram, Lakshmanan AU - Sivasundaram L AD - Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois. FAU - Yanke, Adam B AU - Yanke AB AD - Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois. FAU - Cole, Brian J AU - Cole BJ AD - Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois. Electronic address: brian.cole@rushortho.com. LA - eng PT - Journal Article DEP - 20230426 PL - United States TA - Arthroscopy JT - Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association JID - 8506498 SB - IM EDAT- 2023/04/29 06:04 MHDA- 2023/04/29 06:04 CRDT- 2023/04/28 19:24 PHST- 2022/05/28 00:00 [received] PHST- 2023/03/15 00:00 [revised] PHST- 2023/03/29 00:00 [accepted] PHST- 2023/04/29 06:04 [pubmed] PHST- 2023/04/29 06:04 [medline] PHST- 2023/04/28 19:24 [entrez] AID - S0749-8063(23)00307-9 [pii] AID - 10.1016/j.arthro.2023.03.031 [doi] PST - ppublish SO - Arthroscopy. 2023 Nov;39(11):2327-2338. doi: 10.1016/j.arthro.2023.03.031. Epub 2023 Apr 26.