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3. Association Between Baseline Meniscal Symptoms and Outcomes of Operative and Nonoperative Treatment of Meniscal Tear in Patients With Osteoarthritis

Author

MacFarlane, Lindsey A., Yang, Heidi, Collins, Jamie E., Brophy, Robert H., Cole, Brian J., Spindler, Kurt P., Guermazi, Ali, Jones, Morgan H., Mandl, Lisa A., Martin, Scott, Marx, Robert G., Levy, Bruce A., Stuart, Michael, Safran‐Norton, Clare, Wright, John, Wright, Rick W., Losina, Elena, and Katz, Jeffrey N.

Published
2022
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8. Outcomes of Grade III Medial Collateral Ligament Injuries Treated Concurrently With Anterior Cruciate Ligament Reconstruction: A Multicenter Study

Author

Amendola, Annunziato, Andrish, Jack T., Brophy, Robert H., Flanigan, David C., Jones, Morgan H., Kaeding, Christopher C., Marx, Robert G., Matava, Matthew J., McCarty, Eric C., Parker, Richard D., Reinke, Emily K., Vidal, Armando F., Wolcott, Michelle L., Wright, Rick W., Westermann, Robert W., Spindler, Kurt P., Huston, Laura J., and Wolf, Brian R.

Published
2019
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11. Change in Anterior Cruciate Ligament Graft Choice and Outcomes Over Time

Author

Parker, Richard D., Andrish, Jack T., Jones, Morgan H., Wright, Rick W., Matava, Matthew J., Brophy, Robert H., Marx, Robert G., McCarty, Eric C., Wolcott, Michelle L., Vidal, Armando F., Amendola, Annunziato, Wolf, Brian R., Dunn, Warren R., Kaeding, Christopher C., Pedroza, Angela D., Reinke, Emily K., Huston, Laura J., Hewett, Timothy E., Flanigan, David C., and Spindler, Kurt P.

Published
2017
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13. Factors Associated With High-Grade Lachman, Pivot Shift, and Anterior Drawer at the Time of Anterior Cruciate Ligament Reconstruction

Author

Andrish, Jack T., Jones, Morgan H., Parker, Richard D., McCarty, Eric C., Vidal, Armando F., Wolcott, Michelle L., Marx, Robert G., Amendola, Annunziato, Wolf, Brian R., Flanigan, David C., Kaeding, Christopher C., Brophy, Robert H., Matava, Matthew J., Wright, Rick W., Dunn, Warren R., Magnussen, Robert A., Reinke, Emily K., Huston, Laura J., Hewett, Timothy E., and Spindler, Kurt P.

Published
2016
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16. Identifying Inflammation in Knee Osteoarthritis: Relationship of Synovial Fluid White Blood Cell Count to Effusion‐Synovitis on Magnetic Resonance Imaging.

Author

MacFarlane, Lindsey A., Arant, Kaetlyn R., Kostic, Aleksandra M., Mass, Hanna, Jones, Morgan H., Collins, Jamie E., Losina, Elena, and Katz, Jeffrey N.

Subjects
LEUKOCYTE count, SYNOVITIS, SYNOVIAL fluid, KNEE pain, MAGNETIC resonance imaging, KNEE osteoarthritis, INFLAMMATION
Abstract

Objective: Inflammation is a potential pain generator and treatment target in knee osteoarthritis (OA). Inflammation can be detected on magnetic resonance imaging (MRI) and by synovial fluid white blood cell count (WBC). However, the performance characteristics of synovial fluid WBC for the detection of synovitis have not been established. This study was undertaken to determine the sensitivity and specificity of synovial fluid WBC in identifying inflammation in knee OA using MRI effusion‐synovitis as the gold standard. Methods: We identified records of patients seen at an academic center with a diagnosis code for knee OA, a procedural code for knee aspiration, and a laboratory order for synovial fluid WBC in the same encounter, as well as an MRI within 12 months of the aspiration. MRIs were read for effusion‐synovitis using the MRI OA Knee Score (MOAKS). We dichotomized effusion‐synovitis as 1) none or small, or 2) medium or large. We calculated the sensitivity and specificity of synovial fluid WBC using MRI effusion‐synovitis (medium/large) as the gold standard. We used the Youden index to identify the best cut point. Results: We included 75 patients. Mean ± SD age was 63 ± 12 years, and 69% were female. The synovial fluid WBC was higher in the medium/large effusion‐synovitis group (median 335 [interquartile range (IQR) 312]) than in the none/small group (median 194 [IQR 272]). The optimal cut point was 242, yielding a sensitivity of 71% (95% confidence interval [95% CI] 56–83%) and specificity of 63% (95% CI 41–81%). Conclusion: The sensitivity and specificity of synovial fluid WBC in identifying effusion‐synovitis on MRI were limited. Further research is needed to better understand the association between MRI and effusion‐synovitis measured by synovial fluid and to determine which measure more strongly relates to synovial histopathology and patient outcomes. [ABSTRACT FROM AUTHOR]

Published
2023
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17. Predictors of Return to Activity at 2 Years After Anterior Cruciate Ligament Reconstruction Among Patients With High Preinjury Marx Activity Scores: A MOON Prospective Cohort Study.

Author

Sheean, Andrew J., Jin, Yuxuan, Huston, Laura J., Brophy, Robert H., Cox, Charles L., Flanigan, David C., Jones, Morgan H., Kaeding, Christopher C., Magnussen, Robert A., Marx, Robert G., Matava, Matthew J., McCarty, Eric C., Parker, Richard D., Wolcott, Michelle L., Wolf, Brian R., Wright, Rick W., and Spindler, Kurt P.

Subjects
SCIENTIFIC observation, MULTIVARIATE analysis, ANTERIOR cruciate ligament, HEALTH outcome assessment, PHYSICAL activity, DESCRIPTIVE statistics, ANTERIOR cruciate ligament surgery, DATA analysis software, LONGITUDINAL method
Abstract

Background: Predictors of return to activity after anterior cruciate ligament reconstruction (ACLR) among patients with relatively high preinjury activity levels remain poorly understood. Purpose/Hypothesis: The purpose of this study was to identify predictors of return to preinjury levels of activity after ACLR, defined as achieving a Marx activity score within 2 points of the preinjury value, among patients with Marx activity scores of 12 to 16 who had been prospectively enrolled in the Multicenter Orthopaedic Outcomes Network (MOON) cohort. We hypothesized that age, sex, preinjury activity level, meniscal injuries and/or procedures, and concurrent articular cartilage injuries would predict return to preinjury activity levels at 2 years after ACLR. Study Design: Cohort study; Level of evidence, 2. Methods: All unilateral ACLR procedures from 2002 to 2008 performed in patients enrolled in the MOON, with preinjury Marx activity scores ranging from 12 to 16, were evaluated with a specific focus on return to preinjury activity levels at 2 years postoperatively. Return to activity was defined as a Marx activity score within 2 points of the preinjury value. The proportion of patients able to return to preinjury activity levels was calculated, and multivariable modeling was performed to identify risk factors for patients' inability to return to preinjury activity levels. Results: A total of 1188 patients were included in the final analysis. The median preinjury Marx activity score was 16 (interquartile range, 12-16). Overall, 466 patients (39.2%) were able to return to preinjury levels of activity, and 722 patients (60.8%) were not able to return to preinjury levels of activity. Female sex, smoking at the time of ACLR, fewer years of education, lower 36-Item Short Form Health Survey Mental Component Summary scores, and higher preinjury Marx activity scores were predictive of patients' inability to return to preinjury activity levels. Graft type, revision ACLR, the presence of medial and/or lateral meniscal injuries, a history of meniscal surgery, the presence of articular cartilage injuries, a history of articular cartilage treatment, and the presence of high-grade knee laxity were not predictive of a patient's ability to return to preinjury activity level. Conclusion: At 2 years after ACLR, most patients with high preinjury Marx activity scores did not return to their preinjury level of activity. The higher the preinjury Marx activity score that a patient reported at the time of enrollment, the less likely he/she was able to return to preinjury activity level. Smoking and lower mental health at the time of ACLR were the only modifiable risk factors in this cohort that predicted an inability to return to preinjury activity levels. Continued effort and investigation are required to maximize functional recovery after ACLR in patients with high preinjury levels of activity. [ABSTRACT FROM AUTHOR]

Published
2023
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18. The TeMPO trial (treatment of meniscal tears in osteoarthritis): rationale and design features for a four arm randomized controlled clinical trial

Author

Sullivan, James K., Irrgang, James J., Losina, Elena, Safran-Norton, Clare, Collins, Jamie, Shrestha, Swastina, Selzer, Faith, Bennell, Kim, Bisson, Leslie, Chen, Angela T., Dawson, Courtney K., Gil, Alexandra B., Jones, Morgan H., Kluczynski, Melissa A., Lafferty, Kathleen, Lange, Jeffrey, Lape, Emma C., Leddy, John, Mares, Aaron V., Spindler, Kurt, Turczyk, Jennifer, and Katz, Jeffrey N.

Published
2018
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19. Risk Factors and Predictors of Significant Chondral Surface Change From Primary to Revision Anterior Cruciate Ligament Reconstruction: A MOON and MARS Cohort Study

Author

Magnussen, Robert A., Borchers, James R., Pedroza, Angela D., Huston, Laura J., Haas, Amanda K., Spindler, Kurt P., Wright, Rick W., Kaeding, Christopher C., Allen, Christina R., Anderson, Allen F., Cooper, Daniel E., DeBerardino, Thomas M., Dunn, Warren R., Lantz, Brett A., Mann, Barton, Stuart, Michael J., Albright, John P., Amendola, Annunziato, Andrish, Jack T., Annunziata, Christopher C., Arciero, Robert A., Bach, Bernard R., Jr, Baker, Champ L., III, Bartolozzi, Arthur R., Baumgarten, Keith M., Bechler, Jeffery R., Berg, Jeffrey H., Bernas, Geoffrey A., Brockmeier, Stephen F., Brophy, Robert H., Bush-Joseph, Charles A., Butler, J. Brad, V, Campbell, John D., Carey, James L., Carpenter, James E., Cole, Brian J., Cooper, Jonathan M., Cox, Charles L., Creighton, R. Alexander, Dahm, Diane L., David, Tal S., Flanigan, David C., Frederick, Robert W., Ganley, Theodore J., Garofoli, Elizabeth A., Gatt, Charles J., Jr, Gecha, Steven R., Giffin, James Robert, Hame, Sharon L., Hannafin, Jo A., Harner, Christopher D., Harris, Norman Lindsay, Jr, Hechtman, Keith S., Hershman, Elliott B., Hoellrich, Rudolf G., Hosea, Timothy M., Johnson, David C., Johnson, Timothy S., Jones, Morgan H., Kamath, Ganesh V., Klootwyk, Thomas E., Levy, Bruce A., Ma, C. Benjamin, Maiers, G. Peter, II, Marx, Robert G., Matava, Matthew J., Mathien, Gregory M., McAllister, David R., McCarty, Eric C., McCormack, Robert G., Miller, Bruce S., Nissen, Carl W., O’Neill, Daniel F., Owens, Brett D., Parker, Richard D., Purnell, Mark L., Ramappa, Arun J., Rauh, Michael A., Rettig, Arthur C., Sekiya, Jon K., Shea, Kevin G., Sherman, Orrin H., Slauterbeck, James R., Smith, Matthew V., Spang, Jeffrey T., Svoboda, Steven J., Taft, Timothy N., Tenuta, Joachim J., Tingstad, Edwin M., Vidal, Armando F., Viskontas, Darius G., White, Richard A., Williams, James S., Jr, Wolcott, Michelle L., Wolf, Brian R., and York, James J.

Published
2018
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23. 494 - EVALUATION OF BONE MARROW EDEMA-LIKE LESIONS IN ANTERIOR CRUCIATE LIGAMENT-RECONSTRUCTED PATIENTS USING MRI: A TEN-YEAR FOLLOW-UP STUDY

Author

Ok, Ahmet Hakan, Holden, William, Lartey, Richard, Obuchowski, Nancy, Vayansky, Ike, Subhas, Naveen, Kim, Jeehun, Li, Mei, Eck, Brendan L., Winalski, Carl S., Altahawi, Faysal, Huston, Laura J., Harkins, Kevin D., Knopp, Michael V., Kaeding, Christopher C., Jones, Morgan H., Spindler, Kurt P., and Li, Xiaojuan

Published
2024
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25. 317 - DO EARLY RADIOGRAPHIC CHANGES AT 2 YEARS PREDICT INCREASED PAIN AT 6 YEARS AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION?

Author

Jones, Morgan H., Yalcin, Sercan, Jin, Yuxuan, Sheean, Andrew, Andrish, Jack, Brophy, Robert, Cox, Charles, Dunn, Warren, Flanigan, David, Fleming, Braden, Huston, Laura J., Kaeding, Christopher C., Magnussen, Robert, Matava, Matthew, Parker, Richard, Reinke, Emily, Smith, Matthew, Winalski, Carl S., Wright, Rick, and Spindler, Kurt P.

Published
2024
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26. Surgical Predictors of Clinical Outcomes After Revision Anterior Cruciate Ligament Reconstruction

Author

Allen, Christina R., Anderson, Allen F., Cooper, Daniel E., DeBerardino, Thomas M., Dunn, Warren R., Haas, Amanda K., Huston, Laura J., Lantz, Brett (Brick) A., Mann, Barton, Nwosu, Sam K., Spindler, Kurt P., Stuart, Michael J., Wright, Rick W., Albright, John P., Amendola, Annunziato (Ned), Andrish, Jack T., Annunziata, Christopher C., Arciero, Robert A., Bach, Bernard R., Jr, Baker, Champ L., III, Bartolozzi, Arthur R., Baumgarten, Keith M., Bechler, Jeffery R., Berg, Jeffrey H., Bernas, Geoffrey A., Brockmeier, Stephen F., Brophy, Robert H., Bush-Joseph, Charles A., Butler, J. Brad, V, Campbell, John D., Carey, James L., Carpenter, James E., Cole, Brian J., Cooper, Jonathan M., Cox, Charles L., Creighton, R. Alexander, Dahm, Diane L., David, Tal S., Flanigan, David C., Frederick, Robert W., Ganley, Theodore J., Garofoli, Elizabeth A., Gatt, Charles J., Jr, Gecha, Steven R., Giffin, James Robert, Hame, Sharon L., Hannafin, Jo A., Harner, Christopher D., Harris, Norman Lindsay, Jr, Hechtman, Keith S., Hershman, Elliott B., Hoellrich, Rudolf G., Hosea, Timothy M., Johnson, David C., Johnson, Timothy S., Jones, Morgan H., Kaeding, Christopher C., Kamath, Ganesh V., Klootwyk, Thomas E., Levy, Bruce A., Ma, C. Benjamin, Maiers, G. Peter, II, Marx, Robert G., Matava, Matthew J., Mathien, Gregory M., McAllister, David R., McCarty, Eric C., McCormack, Robert G., Miller, Bruce S., Nissen, Carl W., O’Neill, Daniel F., Owens, Brett D., Parker, Richard D., Purnell, Mark L., Ramappa, Arun J., Rauh, Michael A., Rettig, Arthur C., Sekiya, Jon K., Shea, Kevin G., Sherman, Orrin H., Slauterbeck, James R., Smith, Matthew V., Spang, Jeffrey T., Svoboda, Steven J., Taft, Timothy N., Tenuta, Joachim J., Tingstad, Edwin M., Vidal, Armando F., Viskontas, Darius G., White, Richard A., Williams, James S., Jr, Wolcott, Michelle L., Wolf, Brian R., and York, James J.

Published
2017
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30. LB-007 - RADIOMIC ANALYSIS OF QUANTITATIVE MAGNETIC RESONANCE IMAGING ON KNEE CARTILAGE, MENISCI AND MID-THIGH MUSCLE: ASSOCIATION WITH POST-TRAUMATIC OSTEOARTHRITIS 10 YEARS AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION.

Author

Kim, Kihwan, Zaylor, William, Khan, Sameed, Lartey, Richard, Eck, Brendan L., Li, Mei, Kim, Jeehun, Winalski, Carl S., Altahawi, Faysal, Jones, Morgan H., Huston, Laura J., Harkins, Kevin D., Knopp, Michael V., Kaeding, Christopher C., Spindler, Kurt P., and Li, Xiaojuan

Published
2024
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39. Five‐Year Structural Changes in the Knee Among Patients With Meniscal Tear and Osteoarthritis: Data From a Randomized Controlled Trial of Arthroscopic Partial Meniscectomy Versus Physical Therapy.

Author

Collins, Jamie E., Shrestha, Swastina, Losina, Elena, Marx, Robert G., Guermazi, Ali, Jarraya, Mohamed, Jones, Morgan H., Levy, Bruce A., Mandl, Lisa A., Williams, Emma E., Wright, Rick W., Spindler, Kurt P., and Katz, Jeffrey N.

Subjects
KNEE osteoarthritis, RELATIVE medical risk, CARTILAGE, CONFIDENCE intervals, SYNOVITIS, ARTHROSCOPY, PHYSICAL therapy, TIME, MENISCECTOMY, REGRESSION analysis, TREATMENT effectiveness, DESCRIPTIVE statistics, MENISCUS injuries, SECONDARY analysis, POISSON distribution, EVALUATION
Abstract

Objective: To estimate the risk of magnetic resonance imaging (MRI)–based structural changes in knee osteoarthritis (OA) among individuals with meniscal tear and knee OA, using MRIs obtained at baseline and 18 and 60 months after randomization in a randomized controlled trial of arthroscopic partial meniscectomy (APM) versus physical therapy (PT). Methods: We used data from the Meniscal Tear in Osteoarthritis Research (METEOR) trial. MRIs were read using the MRI OA Knee Score (MOAKS). We used linear mixed‐effects models to examine the association between treatment group and continuous MOAKS summary scores, and Poisson regression to assess categorical changes in knee joint structure. Analyses assessed changes in OA between baseline and month 18 and between months 18 and 60. We performed both intention‐to‐treat and as‐treated analyses. Results: The analytic sample included 302 participants. For both treatment groups, more OA changes were seen during the early interval than during the later interval. ITT analysis revealed that, between baseline and month 18, APM was significantly associated with an increased risk of having a worsening cartilage surface area score, involving both any worsening across all knee joint subregions (risk ratio [RR] 1.35 [95% confidence interval (95% CI) 1.14, 1.61]) and the number of subregions damaged (RR 1.44 [95% CI 1.13, 1.85]) having a worsening effusion‐synovitis score (RR 2.62 [95% CI 1.32, 5.21]), and having ≥1 additional subregion with osteophytes (RR 1.24 [95% CI 1.02, 1.50]). Significant associations were detected between months 18 and 60 only for having any subregion with a worsening osteophyte score (RR 1.28 [95% CI 1.04, 1.58]). Conclusion: These findings suggest that the association between APM and MRI‐based structural changes in knee OA is most apparent during the initial 18 months after surgery. The reason for attenuation of this association over longer follow‐up merits further investigation. [ABSTRACT FROM AUTHOR]

Published
2022
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40. Increased Joint Space Narrowing After Arthroscopic Partial Meniscectomy: Data From the Osteoarthritis Initiative.

Author

Santana, Daniel C., Oak, Sameer R., Jin, Yuxuan, Rothy, Alex, Lee, Ling-Ling, Katz, Jeffrey N., Winalski, Carl S., Duryea, Jeff, and Jones, Morgan H.

Subjects
KNEE radiography, SURGICAL complication risk factors, KNEE osteoarthritis, ARTHROSCOPY, MENISCECTOMY, CASE-control method, MAGNETIC resonance imaging, RISK assessment, COMPARATIVE studies, DESCRIPTIVE statistics, ARTICULAR cartilage, DATA analysis software, MENISCUS injuries, DISEASE risk factors
Abstract

Background: Arthroscopic partial meniscectomy (APM) is widely performed and remains an important therapeutic option for patients with a meniscal tear. However, it is debated whether or not APM accelerates the progression of osteoarthritis (OA) in the long term. Purpose/Hypothesis: The purpose was to compare the progression of OA measured by the change in tibiofemoral joint space width (JSW)—a quantitative measure of OA radiographic severity—across 3 groups with a midterm follow-up: (1) patients undergoing APM; (2) those with a meniscal tear treated nonoperatively; and (3) those without a tear. We hypothesized that the reduction in JSW would be greatest in patients undergoing APM and least in those patients without a tear. Study Design: Cohort study; Level of evidence, 3. Methods: Using the Osteoarthritis Initiative cohort, a total of 144 patients were identified that underwent APM with at least 12 months of follow up and without previous knee surgery. Those with a meniscal tear who did not have APM (n = 144) and those without a tear (n = 144) were matched to patients who had APM by sex, age, Kellgren-Lawrence (KL) grade, and follow up time. Participants underwent magnetic resonance imaging at baseline. Knee radiographs to assess JSW were collected annually or biannually. The change in minimum medial compartment JSW was calculated using a validated automated method. A piecewise linear mixed effects model was constructed to examine the relationship between JSW decline over time and treatment group—adjusting for age, body mass index, smoking status, KL grade, and baseline JSW. Results: All groups had comparable baseline JSW—ranging from 4.33 mm to 4.38 mm. The APM group had a rate of JSW decline of −0.083 mm/mo in the first 12 months and −0.014 mm/mo between 12 and 72 months. The rate of JSW decline in the APM group was approximately 27 times greater in the first 12 months than that in the nonsurgical group (−0.003 mm/mo) and 5 times greater than that in the no tear group (−0.015 mm/mo); however, there was no significant difference between groups for 12 to 72 months (nonsurgical group: −0.009 mm/mo; no tear group: −0.010 mm/mo). The adjusted JSW in the APM group was 4.38 mm at baseline and decreased to 2.57 mm at 72 months; the JSW in the nonsurgical group declined from 4.31 mm to 3.73 mm, and in the no tear group it declined from 4.33 mm to 3.54 mm. There was a statistically significant difference in JSW change between baseline and 72 months for the APM group compared with the other groups (P <.001), but not between the nonsurgical and no tear groups (P =.12). Conclusion: In the first postoperative year, APM results in a faster rate of joint space narrowing compared with knees undergoing nonsurgical management of meniscal tears. Thereafter, there are comparable rates of OA progression regardless of the chosen management. APM results in a persistent decrease in JSW over at least 72 months. An untreated meniscal tear does not contribute to radiographic progression—assessed by JSW—as compared with an intact meniscus. [ABSTRACT FROM AUTHOR]

Published
2022
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42. Which preoperative factors, including bone bruise, are associated with knee pain/symptoms at index anterior cruciate ligament reconstruction (ACLR)? A Multicenter Orthopaedic Outcomes Network (MOON) ACLR Cohort Study

Author

Dunn, Warren R., Spindler, Kurt P., Amendola, Annunziato, Andrish, Jack T., Kaeding, Christopher C., Marx, Robert G., McCarty, Eric C., Parker, Richard D., Harrell, Frank E., Jr., An, Angel Q., Wright, Rick W., Brophy, Robert H., Matava, Matthew J., Flanigan, David C., Huston, Laura J., Jones, Morgan H., Wolcott, Michelle L., Vidal, Armando F., and Wolf, Brian R.

Subjects
Knee pain -- Influence, Knee pain -- Research, Outcome and process assessment (Health Care) -- Research, Health, Sports and fitness
Published
2010

44. Success of meniscal repair at anterior cruciate ligament reconstruction

Author

Toman, Charles V., Dunn, Warren R., Spindler, Kurt P., Amendola, Annunziata, Andrish, Jack T., Bergfeld, John A., Flanigan, David, Jones, Morgan H., Kaeding, Christopher C., Marx, Robert G., Matava, Matthew J., McCarty, Eric C., Parker, Richard D., Wolcott, Michelle, Vidal, Armando, Wolf, Brian R., Huston, Laura J., Harrell, Frank E., Jr., and Wright, Rick W.

Subjects
Orthopedic surgery -- Methods, Orthopedic surgery -- Social aspects, Orthopedic surgery -- Research, Orthopedic surgery -- Patient outcomes, Anterior cruciate ligament -- Injuries, Health, Sports and fitness
Published
2009

45. Opioid Use After Simple Arthroscopic Knee Surgery.

Author

Scarcella, Michael J., Farrow, Lutul D., Jones, Morgan H., Rosneck, James, Briskin, Isaac, and Spindler, Kurt P.

Subjects
DRUG overdose risk factors, PAIN measurement, ARTHROSCOPY, AGE distribution, CASE-control method, SURGERY, PATIENTS, MENTAL health, HEALTH outcome assessment, RISK assessment, DESCRIPTIVE statistics, DRUG utilization, BODY mass index, SMOKING, KNEE surgery, POSTOPERATIVE pain, LONGITUDINAL method, EDUCATIONAL attainment, OUTPATIENT services in hospitals
Abstract

Background: Evidence-based prescribing guidelines are lacking for opioids after most orthopaedic surgical procedures. Hypothesis: Opioids are commonly overprescribed after simple knee arthroscopy. Study Design: Case-control study; Level of evidence, 3. Methods: A cohort of 174 patients who underwent simple arthroscopic knee surgery were prospectively evaluated using data from the Outcome Management and Evaluation database. All patients received 10 combined hydrocodone 5 mg and acetaminophen 325 mg pills postoperatively. Patients were excluded if they (1) had revision surgery, (2) had concomitant complex surgery (eg, ligament surgery, osteotomy), (3) had current opioid use, (4) had open surgery for removal of hardware, (5) or had bilateral knee surgery. Total opioid consumption was reported at the first postoperative visit, and a distribution was created based on patient response. Based on the distribution, patients were separated into low (0-2 pills) versus high (3 or more pills) opioid consumption groups for evaluating risk factors for opioid use. The risk factors included were age, body mass index, smoking status, education level, baseline pain (Knee injury and Osteoarthritis Outcome Score pain subscale [KOOS Pain]), and baseline mental health (Veterans RAND 12-Item Health Survey Mental Component Score), as well as intraoperative findings such as synovial characteristics and extent of osteoarthritis in the multivariate model. Results: Total opioid consumption ranged from 0 to 19 pills. The median pill count was 2 (25th; 75th interquartile range, 0; 4). Of total patients, 59% were categorized as having low opioid consumption, and the remaining 41% were in the high opioid consumption group. Only 23 patients (13.2%) took 6 or more pills. Preoperative pain as measured by KOOS Pain score was a significant predictor of high opioid consumption postoperatively (odds ratio, 0.97; 95% CI, 0.95-0.99; P =.003). Conclusion: The clinically relevant conclusion is that opioids are overprescribed after simple arthroscopic knee surgery. Based on distribution, the authors recommend that 4 pills be prescribed after simple arthroscopic knee surgery. After accounting for confounding variables, preoperative pain was associated with higher postoperative opioid consumption. [ABSTRACT FROM AUTHOR]

Published
2022
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46. Syndesmotic ankle sprains in athletes

Author

Williams, Glenn N., Jones, Morgan H., and Amendola, Annunziato

Subjects
Ankle -- Injuries, Athletes -- Injuries -- Health aspects, Sports injuries -- Diagnosis -- Care and treatment, Health, Sports and fitness, Diagnosis, Care and treatment, Injuries, Health aspects
Abstract

Ankle sprains are among the most common athletic injuries and represent a significant source of persistent pain and disability. Despite the high incidence of ankle sprains in athletes, syndesmosis injuries [...]

Published
2007

47. Surgery versus Physical Therapy for a Meniscal Tear and Osteoarthritis

Author

Katz, Jeffrey N., Brophy, Robert H., Chaisson, Christine E., de Chaves, Leigh, Cole, Brian J., Dahm, Diane L., Donnell-Fink, Laurel A., Guermazi, Ali, Haas, Amanda K., Jones, Morgan H., Levy, Bruce A., Mandl, Lisa A., Martin, Scott D., Marx, Robert G., Miniaci, Anthony, Matava, Matthew J., Palmisano, Joseph, Reinke, Emily K., Richardson, Brian E., Rome, Benjamin N., Safran-Norton, Clare E., Skoniecki, Debra J., Solomon, Daniel H., Smith, Matthew V., Spindler, Kurt P., Stuart, Michael J., Wright, John, Wright, Rick W., and Losina, Elena

Published
2013
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