Summary

Meniscal repair failure risk and patient reported outcomes do not differ substantially between older or younger patients of similar activity level.

Abstract

Purpose

To determine whether patient age group (40 years or older versus under 40 years) and pre-injury activity level are independently predictive of meniscus repair failure risk and patient-reported outcomes at mean 5-years follow-up.

Methods

225 patients (n=61 age = 40 years; n=164 age <40; 11% sedentary, 64% recreational athletes, 26% competitive athletes; 72% of athletes in cutting-pivoting sports) who underwent meniscus repair were assessed for meniscus repair failure and patient-reported knee function at mean 5.4 years follow-up (SD 2.8). Knee symptoms were assessed with the Knee Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee Subjective (IKDC-S) scores, and post-operative activity scores were assessed with the Marx Activity score. The independent effects of patient age and activity level on meniscus repair failure risk and patient-reported outcomes were determined by multivariate modeling with adjustment for body mass index, sex, ACL status, tear pattern, chondral status, and number of implants utilized at the time of surgery.

Results

Meniscus repair failure risk was 20% overall and was not associated with age (p=0.41) or participation in recreational (p=0.31) or competitive (p=0.16) sports relative to a sedentary lifestyle. IKDC-S scores were not associated with age (p=0.12), but were lower among sedentary patients (adjusted mean 59.6 SE 4.9) compared to recreational (78.9 SE 2.5; p=0.007) or competitive athletes (79.2 SE 3.8; p=0.02). KOOS-ADL scores were higher among patients under age 40 years (mean 90.3, SE 1.4) compared to patients =40 (mean 82.7, SE 2.7; p=0.01) but not KOOS-pain, KOOS-sport, or KOOS-QOL (p>0.05). Sedentary status was independently associated with lower KOOS scores for all subscores (p<0.05).

Conclusions

Meniscal repair failure risk and patient reported outcomes do not differ substantially between older or younger patients of similar activity level. Sedentary patients regardless of age have worse self-reported subjective outcomes compared to active patients following meniscus repair.