title: Successful conservative treatment of patients with MRI-verified meniscal lesions.
abstract: OBJECTIVE
  To follow a prospective cohort of consecutive patients with MRI-verified meniscal lesions to identify pre-treatment prognostic factors for long-term results following arthroscopic or conservative treatment.
  
  
  METHODS
  In the course of 1 year, 291 patients with knee pain and clinically suspected of meniscal lesion were referred to the regional orthopaedic division and subjected to MRI and clinical examination by an experienced surgeon. Patients with MRI-verified meniscal lesions were treated according to an arthroscopy restrictive strategy meaning that treatment was initiated by conservative treatment. Arthroscopy was only performed if satisfying pain relief was not obtained. The Lysholm score and Knee Injury and Osteoarthritis Outcome Score (KOOS) were obtained at baseline and after 12-24 months. A multiple linear regression model was used to investigate which pre-treatment prognostic factors were associated with improvement in the KOOS subscale pain from baseline to follow-up.
  
  
  RESULTS
  An MRI-verified meniscal lesion was found in 185 patients (64%). Among these, 58% were treated successfully by conservative treatment. A high KOOS subscale pain score at baseline was associated with less improvement from baseline to follow-up. Bucket-handle lesions were associated with larger improvement from baseline to follow-up compared to flap-tear lesions.
  
  
  CONCLUSIONS
  MRI findings and clinical status measured by KOOS subscale pain are prognostic for improvement among patients treated for MRI-verified meniscal lesions. Good results were observed for both operative and conservative treatment. The success rate for conservative treatment was 58%.
  
  
  METHODS
  Prospective cohort study, Level II.
authors.affiliation: Orthopaedic Surgery Research Unit, Research and Innovation Center, Aalborg University Hospital, 15 Soendre Skovvej, 9000, Aalborg, Denmark , camilla.r.knudsen@gmail.com.
authors.forename: Camilla Rams
authors.initials: CR
authors.lastname: Rathleff
authors.forename: Christian
authors.initials: C
authors.lastname: Cavallius
authors.forename: Hans Peter
authors.initials: HP
authors.lastname: Jensen
authors.forename: Ole Højgaard
authors.initials: OH
authors.lastname: Simonsen
authors.forename: Sten
authors.initials: S
authors.lastname: Rasmussen
authors.forename: Søren
authors.initials: S
authors.lastname: Kaalund
authors.forename: Svend Erik
authors.initials: SE
authors.lastname: Østgaard
mesh_terms: D000328:Adult; D001182:Arthroscopy; D005260:Female; D006801:Humans; D065466:Lysholm Knee Score; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D010147:Pain Measurement; D063868:Patient Outcome Assessment; D011379:Prognosis; D011446:Prospective Studies; D000070600:Tibial Meniscus Injuries