Background:

Arthroscopic partial meniscectomy is one of the most common procedures in orthopaedic surgery. The patient acceptable symptomatic state (PASS), which defines a level of symptoms above which patients consider themselves well, remains to be well-defined in this population.

Purpose:

Using an anchor-based approach, our goal was to determine the 1-year PASS for the Knee injury and Osteoarthritis Outcome Score (KOOS), the International Knee Documentation Committee (IKDC) Subjective Knee Form, the Western Ontario Meniscal Evaluation Tool (WOMET), and the Marx Activity Scale (MAS) in patients who were treated with partial knee meniscectomy.

Study Design:

Case series; Level of evidence, 4.

Methods:

A consecutive series of patients with knee meniscal tears and a Kellgren-Lawrence grade of 0 to 2 treated with arthroscopic partial meniscectomy were eligible. The KOOS (0-100), IKDC (0-100), WOMET (0-100), and MAS (0-16) were administered at baseline and 12 months postoperatively. An external anchor question at 1 year postoperatively was used to determine PASS values. A receiver operating characteristic curve (ROC) analysis was used to determine the PASS value at which patients considered their status to be satisfactory.

Results:

The study included 110 patients (mean ± SD age, 53.8 ± 12.0 years), 57.3% were male, and the follow-up rate was 82%. In total, 70% of patients had an Outerbridge arthroscopic grade of 2 or lower. Based on ROC analysis, the 1-year postoperative PASS values (sensitivity, specificity) were 64.3 (47.8, 100.0) for KOOS Symptoms, 81.6 (71.6, 100.0) for KOOS Pain, 82.4 (82.1, 86.4) for KOOS Function in Daily Living, 71.0 (62.7, 81.8) for KOOS Function in Sport and Recreation, 51.0 (83.6, 95.5) for KOOS Knee-Related Quality of Life, 56.2 (82.1, 100.0) for IKDC, 58.5 (79.1, 100.0) for WOMET, and 7.0 (44.8, 68.2) for MAS. Baseline scores did not affect the PASS threshold across the different instruments. However, patients with higher baseline scores were more likely to achieve the PASS for the KOOS Symptoms (odds ratio [OR], 2.808; P = .047), IKDC (OR, 4.735; P = .006), and WOMET (OR, 2.985; P = .036). Age, sex, and cartilage status were not significantly related to the odds of achieving the PASS for any of the patient-reported outcome measures.

Conclusion:

These findings allow researchers and clinicians to determine whether partial meniscectomy is meaningful to patients at the individual level and will be helpful for responder analysis in future trials related to the treatment of meniscal abnormality.

中文翻译：

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确定正在接受膝关节镜部分半月板切除术的患者的患者可接受的症状状态。

背景：

关节镜下半月板切除术是骨科手术中最常见的手术之一。患者可接受的症状状态（PASS）定义了症状水平，高于该水平患者认为自己感觉良好，在此人群中仍有待明确定义。

目的：

使用基于锚的方法，我们的目标是确定膝关节损伤和骨关节炎结果评分（KOOS）的1年PASS，国际膝关节文献委员会（IKDC）主观膝关节表格，西安大略省半月板评估工具（WOMET） ，以及接受部分半月板切除术治疗的患者的马克思活动量表（MAS）。

学习规划：

案例系列；证据水平4。

方法：

连续接受膝关节半月板撕裂且关节镜部分半月板切除术治疗的Kellgren-Lawrence评分为0至2的一系列患者是合格的。KOOS（0-100），IKDC（0-100），WOMET（0-100）和MAS（0-16）在基线和术后12个月给药。术后1年使用外部锚定问题确定PASS值。使用接收器工作特征曲线（ROC）分析来确定患者认为其状态令人满意的PASS值。

结果：

该研究纳入110例患者（平均±SD年龄，53.8±12.0岁），男性为57.3％，随访率为82％。总计，有70％的患者的外桥关节镜评分为2或更低。根据ROC分析，KOOS症状术后1年的PASS值（敏感性，特异性）为64.3（47.8，100.0），KOOS疼痛为81.6（71.6，100.0），KOOS在日常生活中的功能为82.4（82.1，86.4） ，对于运动和娱乐中的KOOS功能为71.0（62.7，81.8），对于与KOOS膝盖相关的生活质量为51.0（83.6，95.5），对于IKDC为56.2（82.1，100.0），对于WOMET为58.5（79.1，100.0），以及7.0 （44.8，68.2）对于MAS。基线分数不会影响不同仪器的PASS阈值。但是，基线评分较高的患者更有可能达到KOOS症状的PASS（比值比[OR]为2.808；P = .047），IKDC（OR，4.735; P = .006）和WOMET（OR，2.985 ; P = .036）。对于任何患者报告的结局指标，年龄，性别和软骨状态与实现PASS的几率均无显着相关。

结论：

这些发现使研究人员和临床医生能够确定半月板切除术对个体水平的患者是否有意义，并将有助于在与半月板异常治疗相关的未来试验中对反应者进行分析。