Effect of Patient Resilience on Functional Outcomes After Meniscectomy

Recent literature has identified that patient resilience may affect outcomes after meniscectomy. Research into psychological risk factors for poor surgical outcomes has been a focus in orthopaedic surgery.

The purpose of this study was to examine the relationship between preoperative patient resilience and 2-year postoperative outcomes after arthroscopic meniscectomy. It was hypothesized that there would be no relationship between resilience and patient-reported outcomes after meniscectomy.

Cohort study; Level of evidence, 2.

Patients who underwent meniscectomy between January and June 2020 at a single multicenter institution were identified, and those aged ≥18 years without evidence of significant osteoarthritis who completed the brief resilience scale (BRS) preoperatively were considered for inclusion. Included patients completed the International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR), Single Assessment Numeric Evaluation (SANE), and visual analog scale (VAS) for pain at a minimum of 2 years postoperatively. Based on BRS scores, patients were stratified into low resilience (LR), normal resilience (NR), and high resilience (HR) groups, and differences and changes in outcomes were compared among the groups using the analysis of variance or the Kruskal-Wallis test for continuous data and the chi-square test for categorical data.

Overall, 100 patients were included (LR group, n = 17; NR group, n = 65; HR group, n = 18). Patients with higher preoperative resilience had higher preoperative IKDC (P = .004) and KOOS-JR (P = .003) scores. However, resilience was not a fixed construct: The median BRS increased in the LR group and decreased in the HR group from pre- to postoperatively (+0.17 and -0.58, respectively; P = .001). At the 2-year follow-up, there was no difference in patient-reported outcome scores across resilience groups, nor was there a difference in the change in IKDC or KOOS-JR scores. Although a positive correlation was observed between preoperative resilience and preoperative IKDC (r _S = 0.331) and KOOS-JR (r _S = 0.334) scores, preoperative resilience did not correlate with postoperative or 2-year improvements in IKDC or KOOS-JR scores. A weak positive correlation was observed between postoperative resilience and postoperative IKDC (r _S = 0.229) and SANE (r _S = 0.202) scores, and a weak negative correlation was observed between postoperative resilience and VAS pain scores (r _S = ∓0.256).

Our study indicated that preoperative patient resilience was not predictive of functional outcome scores at a 2-year follow-up after arthroscopic meniscectomy.