Date of Award

2-23-2009

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Peter Jokl

Abstract

Patients undergoing orthopaedic surgery are concerned with returning to activities of daily living (recovery) in addition to the long-term result of their surgery (end result). As evidence of predictors of rate of short-term recovery is limited to date, this study seeks to determine which patient clinical and demographic factors can serve as prognostic indicators for rate of short-term recovery from arthroscopic partial meniscectomy in the year following surgery and how they may differ from previously published associations with long-term outcome. Clinical (depth of meniscal excision, involvement of one or both menisci, extent of meniscal tear, extent of osteoarthritis) and demographic (age, gender, and BMI) measurements were obtained pre- and intraoperatively. Mixed model repeated measures analyses were used longitudinally to identify independent predictors of rate of recovery, measured by prospectively assessing knee pain, knee function, and overall physical knee status pre-operatively and at regular intervals throughout postoperative recovery out to one year. Of the clinical variables, only greater extent of osteoarthritis was associated with slower rate of recovery over all three recovery measures. Greater depth of meniscal excision was associated only with poorer overall physical knee status, but not postoperative knee pain or function. Of the demographic predictor variables, female gender was associated with poorer scores over all three recovery variables over time, while age and body mass index (BMI) had no association with rate of recovery. Factors affecting short-term rate of recovery are different than associations with longterm outcome. Previous research has shown poorer long-term outcome with advanced age, greater BMI, and greater amount of meniscal tissue excision. This research indicates that female gender and worse osteoarthritis at the time of surgery are associated with a slower rate of short-term recovery from arthroscopic partial meniscectomy, while age, obesity, and amount of meniscal tear/resection show no association with recovery scores over time throughout the first year postoperatively.

Comments

This is an Open Access Thesis.

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