PMID- 38164686 OWN - NLM STAT- MEDLINE DCOM- 20240103 LR - 20240213 IS - 1552-3365 (Electronic) IS - 0363-5465 (Linking) VI - 52 IP - 1 DP - 2024 Jan TI - Preoperative Predictors of Arthroscopic Partial Meniscectomy Outcomes: The APM Index Score. PG - 116-123 LID - 10.1177/03635465231210303 [doi] AB - BACKGROUND: Preoperative risk factors contributing to poor outcomes after arthroscopic partial meniscectomy (APM) have not yet been consolidated and codified into an index scoring system used to predict APM success. PURPOSE: To create an index score using available preoperative factors to predict the likelihood of favorable postoperative outcomes after APM. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: A consecutive cohort of patients undergoing primary APM were enrolled in this study. Patients completed pre- and postoperative patient-reported outcome measure (PROM) questionnaires that included the Knee injury and Osteoarthritis Outcome Score (KOOS), visual analog scale (VAS) for pain, Veterans RAND 12-Item Health Survey (VR-12 Physical and Mental), and Marx Activity Rating Scale (MARS). Multivariable logistic regression models were performed to evaluate independent predictors of KOOS Pain, Symptoms, and Activities of Daily Living scores and achievement of the minimal clinically important difference (MCID) and substantial clinical benefit (SCB). The authors assigned points to each variable proportional to its odds ratio, rounded to the nearest integer, to generate the index score. RESULTS: In total, 468 patients (mean age, 49 years [SD, 10.4 years; range, 19-81 years]) were included in this study. In the univariate analysis, shorter symptom duration, lower Kellgren-Lawrence (KL) grade, lower preoperative KOOS Pain value, and lower VR-12 Physical score were associated with a higher likelihood of clinical improvement at 1 year. In the multivariable model for clinical improvement with MCID, symptom duration (<3 months: OR, 3.00 [95% CI, 1.45-6.19]; 3-6 months: OR, 2.03 [95% CI, 1.10-3.72], compared with >6 months), KL grade (grade 0: OR, 3.54 [95% CI, 1.66-7.54]; grade 1: OR, 3.04 [95% CI, 1.48-6.26]; grade 2: OR, 2.31 [95% CI, 1.02-5.27], compared with grade 3), and preoperative KOOS Pain value (score <45: OR, 3.00 [95% CI, 1.57-5.76]; score of 45-60: OR, 2.80 [95% CI, 1.47-5.35], compared with score >60) were independent significant predictors for clinical improvement. The scoring algorithm demonstrated that a higher total score predicted a higher likelihood of achieving the MCID: 0 = 40%, 1 = 68%, 2 = 80%, 3 = 89%, and 4 = 96%. CONCLUSION: Using this model, the authors developed an index score that, using preoperative factors, can help identify which patients will achieve clinical improvement after APM. Longer symptom duration and higher KL grade were associated with a decreased likelihood of clinical improvement as measured by KOOS Pain at 1 year postoperatively. FAU - Lowenstein, Natalie A AU - Lowenstein NA AUID- ORCID: 0000-0003-0083-9167 AD - Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. FAU - Chang, Yuchiao AU - Chang Y AUID- ORCID: 0000-0003-1093-3755 AD - Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. FAU - Mass, Hanna AU - Mass H AUID- ORCID: 0000-0002-1686-0801 AD - Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. FAU - Mercurio, Angela M AU - Mercurio AM AD - Harvard Medical School, Boston, Massachusetts, USA. Presented at the annual meeting of the AOSSM, Washington, DC, July 2023. FAU - Ukogu, Chierika AU - Ukogu C AD - Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. FAU - Katz, Jeffrey N AU - Katz JN AD - Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. FAU - Matzkin, Elizabeth G AU - Matzkin EG AD - Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. LA - eng PT - Journal Article PL - United States TA - Am J Sports Med JT - The American journal of sports medicine JID - 7609541 SB - IM MH - Humans MH - Middle Aged MH - *Meniscectomy MH - Case-Control Studies MH - *Activities of Daily Living MH - Pain/etiology MH - Arthroscopy/adverse effects MH - Patient Reported Outcome Measures MH - Treatment Outcome OTO - NOTNLM OT - PROMs OT - index score OT - knee arthroscopy OT - meniscal tear OT - meniscectomy COIS- One or more of the authors has declared the following potential conflict of interest or source of funding: J.N.K. has received honoraria from Pfizer. E.G.M. has received support for education from Peerless Surgical and Kairos Surgical. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. EDAT- 2024/01/02 11:43 MHDA- 2024/01/03 09:44 CRDT- 2024/01/02 04:13 PHST- 2024/01/03 09:44 [medline] PHST- 2024/01/02 11:43 [pubmed] PHST- 2024/01/02 04:13 [entrez] AID - 10.1177/03635465231210303 [doi] PST - ppublish SO - Am J Sports Med. 2024 Jan;52(1):116-123. doi: 10.1177/03635465231210303.