The association between chondral lesions and patient-reported outcomes after meniscectomy: Data from the Osteoarthritis Initiative

<h2>Abstract</h2><h3>Introduction</h3> Evidence and guidelines around the treatment of meniscal tears in patients with knee osteoarthritis (OA) are conflicting, and the impact of chondral damage on surgical outcomes is unclear. <h3>Objective</h3> Our objective was to evaluate patient-reported outcomes (PROs) following meniscectomy and to determine whether the extent of chondral damage is associated with worse outcomes. <h3>Methods</h3> We utilized data from the Osteoarthritis Initiative and selected participants with radiographic knee OA (Kellgren-Lawrence grades 2 and 3) and magnetic resonance imaging (MRI) available. We identified the MRI before meniscectomy and measured lesion area on sagittal intermediate-weighted fat-suppressed and axial reformatted Double Echo Steady State MRI. The primary analysis included knees with pain in the year preceding arthroscopic surgery (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] Pain > 20) and femoral lesion area >2 cm². Secondary analysis included all knees. <h3>Results</h3> The primary analysis included 66 participants. Average improvements in PROs 2 years postsurgery were 13.2, 7.6, and 12.1 for WOMAC Pain, WOMAC Function, and Knee Injury and Osteoarthritis Outcome Score (KOOS) Pain, respectively. WOMAC Pain improvements were 10.6 (95% confidence interval: 2.3, 18.9) in those with femoral lesion area 2 to 9 cm² and 15.1 (95% confidence interval: 8.1, 22.0) in those with femoral lesion area ≥9 cm². Results were consistent in secondary analyses. <h3>Conclusions</h3> Participants with radiographic knee OA undergoing meniscectomy reported improvements in PROs. Total femoral lesion area varied considerably, but we did not find associations between lesion area and PROs. These preliminary findings suggest that meniscectomy outcomes do not vary by chondral lesion extent in patients with Kellgren-Lawrence grades 2 and 3 OA.