Association between structural change over 18 months and subsequent symptom change in middle-aged persons treated for meniscal tear.

BACKGROUND Middle-aged subjects with meniscal tear treated with arthroscopic partial meniscectomy (APM) experience greater progression of damage to joint structures on imaging than subjects treated nonoperatively. It is unclear whether these changes are clinically relevant. METHODS We used data from the MeTeOR (Meniscal Tear in Osteoarthritis Research) Trial of APM vs. physical therapy for subjects ≥ 45 years with knee pain, cartilage damage, and meniscal tear. We assessed whether change in cartilage surface area damage score (and other structural measures) from baseline to 18 months, assessed on MRI with MOAKS (MRI Osteoarthritis Knee Score), was associated with change in KOOS Pain (Knee Injury and Osteoarthritis Outcome Score; 0-100, 100=worst) from 18-60 months. RESULTS The primary analysis included 168 subjects with complete MRI data at baseline and 18 months and KOOS data at 18 and 60 months. We did not observe clinically important associations between change in cartilage surface area score between baseline and 18 months and change in pain scores from 18-60 months. Pain scores in the worst tertile for cartilage surface area damage score progression worsened by 0.45 points more than in the best tertile (95% CI -4.45, 5.35). Similarly, we did not observe clinically important associations between changes in bone marrow lesions, osteophytes, or synovitis and subsequent pain. CONCLUSIONS We did not observe clinically important associations between early changes in cartilage damage and other structural measures and worsening in pain over the subsequent 3.5 years. Further follow-up is required to assess this association over a longer follow-up period.