Purpose
To determine whether knee arthroscopy alleviates the symptom constellation of knee
grinding/clicking, catching/locking, and pivot pain.
Methods
One-year follow-up data from 584 consecutive subjects who underwent knee arthroscopy
from August 2012 to December 2019 were collected prospectively. Subjects reported
frequency of knee grinding/clicking, catching/locking, and/or pivot pain preoperatively
and 1 and 2 years postoperatively. A single surgeon performed each procedure and documented
all intraoperative pathology. We measured the postoperative resolution or persistence
of these symptoms and used multivariable regression models to identify preoperative
demographic and clinical variables that predicted symptom persistence. We also assessed
changes in the Pain, Activities of Daily Living, and Quality of Life subscales of
the Knee Injury and Osteoarthritis Outcome Score (KOOS).
Results
Postoperative symptom resolution was more likely for grinding/clicking (65.6%) and
pivot pain (67.8%) than for catching/locking (44.1%). Smoking status, overweight/obesity,
absence of meniscal tear, and number of compartments with focal cartilage lesions
predicted persistence of 1 or more patient-reported knee symptoms. KOOS subscale scores
consistently improved by at least one standard deviation. Individuals who had resolution
of patient-reported knee symptoms exhibited roughly 2-fold improvements in KOOS Pain,
ADL and Quality of Life scores compared with those whose symptoms persisted. Persistence
of pivot pain was associated with the least improvement of the 3 KOOS subscales.
Conclusions
Two in three patients with grinding/clicking or pivot pain experience symptom resolution
after knee arthroscopy, although catching/locking is more likely to persist. Smoking
status, overweight/obesity, absence of meniscal tear, and number of compartments with
focal cartilage lesions predict symptom persistence after knee arthroscopy.
Level of Evidence
Therapeutic Level IV, retrospective cohort analysis of prospective data.
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Article info
Publication history
Published online: July 12, 2022
Accepted:
June 26,
2022
Received:
December 14,
2021
Footnotes
See commentary on page 100
The authors report the following potential conflicts of interest or sources of funding: J.N.K. reports grants from Biosplice, outside the submitted work. ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2022 by the Arthroscopy Association of North America
