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Time to Achieving Clinically Significant Outcomes After Meniscal Allograft Transplantation
Hailey P Huddleston1, Evan M Polce1, Ron Gilat1
1Rush University Medical Center, Chicago, IL, USA.
Purpose:
To determine the time to achieving minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) for commonly administered patient-reported outcome (PRO) measures and risk factors affecting achievement of clinically significant outcomes in patients undergoing meniscal allograft transplantation (MAT).
Methods:
A prospectively maintained MAT registry was retrospectively reviewed from April 2014 to May 2019. Patients who underwent revision MAT or did not complete preoperative PROs or one post operative time point were excluded. Patients who underwent concomitant procedures were included in the analysis. PROs were administered preoperatively and at 6 months, 1 year, and 2 years postoperatively. Previously defined MCID and PASS thresholds were utilized and Kaplan-Meier survival curve analysis with interval censoring was used to calculate the cumulative percentages of MCID and PASS achievement at each follow-up time interval (5-7, 11-13, and 23-25 months).
Results:
Eighty patients (age: 28.35 ± 9.76, 50% male) who completed preoperative, 6-month (n = 69, 86% compliance), and 1-year (n = 76, 95% compliance) PROs were included. The majority of patients (>50%) achieved MCID and PASS on most included PROs. Workers' compensation status was found to significantly delay achievement of MCID and PASS on all PROs except for PASS on Knee Injury and Osteoarthritis Outcome Score (KOOS) quality of life (QoL). Higher body mass index (BMI) significantly delayed time to achieving MCID on KOOS Pain and activities of daily living (ADL), as well as PASS on KOOS Symptoms and KOOS QoL.
Conclusion:
This study suggests that the majority of patients have clinically significant improvements in pain and function after MAT, with more than 50% of patients experiencing clinically significant improvement within the first postoperative year. Workers' compensation status and high BMI may prolong time to achievement of MCID and PASS after MAT.
Insights
Most patients achieve significant improvement after meniscal allograft transplantation (MAT). However, workers' compensation and higher BMI may delay achieving minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS).
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Rehabilitation Medicine
Background:
- Meniscal allograft transplantation (MAT) is a surgical procedure aimed at restoring knee function.
- Assessing patient-reported outcomes (PROs) is crucial for evaluating the success of MAT.
- Understanding the timeline for achieving clinically significant improvements is vital for patient expectations and recovery management.
Purpose of the Study:
- To determine the time to achieving minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) after MAT.
- To identify risk factors influencing the achievement of clinically significant outcomes following MAT.
Main Methods:
- Retrospective review of a prospectively maintained MAT registry (April 2014 - May 2019).
- Inclusion of patients who completed PROs preoperatively and at 6 months, 1 year, and 2 years postoperatively.
- Kaplan-Meier survival curve analysis with interval censoring to calculate MCID and PASS achievement rates.
Main Results:
- The majority of patients (>50%) achieved MCID and PASS on most PRO measures within the first postoperative year.
- Workers' compensation status significantly delayed MCID and PASS achievement across most PROs.
- Higher body mass index (BMI) was associated with delayed achievement of MCID and PASS on several KOOS subscales.
Conclusions:
- Most patients experience clinically significant improvements in pain and function within one year after MAT.
- Workers' compensation status and elevated BMI are potential risk factors that may prolong recovery time after MAT.
- These findings highlight the importance of considering patient-specific factors in managing expectations and recovery following MAT.
