Objective: Describe the clinical course and predictors of change in self-reported outcomes and objectively assessed physical function over time in middle-aged subjects at high risk of, or with knee osteoarthritis (OA).
Methods: We examined 259 subjects (mean age 52.6 [SD 10.4]) at mean 18 and 25 years after previous meniscectomy and 50 population-based age- and sex-matched reference subjects with the Knee injury and Osteoarthritis Outcome Score (KOOS), one-leg hop for distance and number of knee-bendings in 30 seconds. Radiographic OA was defined as equivalent to Kellgren & Lawrence grade 2 or worse.
Results: At first assessment, meniscectomized subjects reported worse pain, function and quality of life compared with the reference group (p<0.001). They also performed fewer knee-bendings per 30 sec (27 vs. 31, p=0.02). The meniscectomized patients worsened over the 4 to 10 year observation time in all measured outcomes (p<0.001), and to a greater extent than the reference group in pain (-5, 95% CI -10,0) and one-leg hop (-11, 95% CI -18,-3). Being a woman, or having radiographic knee OA, enhanced the worsening in both self-reported and objectively assessed outcomes. Older age and a higher BMI influenced objectively assessed physical function, but not self-reported outcomes.
Conclusion: Worsening over time in knee-related pain and function is greater in meniscectomized subjects compared with reference subjects. Rehabilitative efforts may be warranted in middle-aged meniscectomized patients, especially in women and those who have developed radiographic knee OA, who are at greater risk of worsening.