Does Surgery for Concomitant Cruciate and Meniscus Injuries Increase or Decrease Subsequent Comorbidities at 2 Years?

Area of Science:

• Orthopedics
• Sports Medicine
• Health Services Research

Background:

• Concurrent cruciate and meniscus knee injuries are common sequelae of acute trauma, often necessitating surgical intervention.
• Post-injury and post-treatment lifestyle adjustments can lead to the development of comorbidities.
• Understanding comorbidity shifts is crucial for comprehensive patient management following knee injuries.

Purpose of the Study:

• To compare comorbidity prevalence between surgical and nonsurgical management of concurrent knee cruciate and meniscus injuries.
• To investigate the impact of surgical intervention on the odds of developing new or worsening existing comorbidities.
• To analyze comorbidity trends in Military Health System beneficiaries over a 36-month period.

Main Methods:

• Retrospective case-control study design utilizing 36-month data (12 months pre-injury/surgery, 24 months post-injury/surgery).
• Inclusion of 2,438 Military Health System beneficiaries with concurrent cruciate and meniscus injuries.
• Logistic regression analysis to assess the association between surgical intervention and comorbidity development.

Main Results:

• A significant proportion (79.1%) of patients underwent surgical intervention, while 20.9% received nonoperative management.
• Surgical intervention was associated with significant within-group changes in comorbidities; approximately half increased (e.g., anxiety, PTSD) and half decreased (e.g., chronic pain, depression).
• Logistic regression confirmed that surgery altered the odds of acquiring specific comorbid diagnoses, with mixed increases and decreases.

Conclusions:

• Surgical treatment for concurrent knee cruciate and meniscus injuries leads to a complex pattern of comorbidity changes.
• The study highlights a significant bidirectional shift in comorbidities post-surgery, necessitating tailored patient care strategies.
• This research provides novel insights into comorbidity dynamics in this patient population, establishing a baseline for future investigations.