Differences in pretreatment symptoms of patients receiving injections or surgery to treat cartilage lesions of the knee: an International Cartilage Regeneration and Joint Preservation Society Patient Registry Study

Introduction

Some patients with cartilage defects of the knee are known to report similar quality of life (QoL) scores to patients listed for total knee arthroplasty. However, it is unknown whether patients waiting to undergo injections for a cartilage injury perceive their symptoms and QoL to be equivalent to those awaiting surgery.

Objectives

Compare the pretreatment status of patients undergoing a knee injection or surgical intervention for cartilage lesions. The hypothesis was that there would be no clinical difference in scores between the 2 cohorts.

Methods

Anonymous data from the International Cartilage Regeneration and Joint Preservation Society Registry were exported: demographics, type of intervention, pretreatment Knee Injury and Osteoarthritis Outcome Scores (KOOS) and Visual Analog Scores (VAS). The required sample size was 273 per cohort. Statistical analyses were used to compare the scores of each cohort (α = 0.05).

Results

One thousand five hundred seventy-eight patients were included (993 surgeries vs 585 injections). The surgical cohort was 30 years younger than the injection cohort (P < .0001). There were no clinically significant differences in KOOS or VAS. However, KOOS aggregate scores, KOOS pain, and VAS were statistically poorer in the injection cohort (P < .0001; P = .04; P = .001). KOOS QoL was poorer in the surgical cohort (P < .0001).

Conclusions

Our null hypothesis was accepted, as there were no clinically significant differences in the scores. Thus, both cohorts perceived their level of disability and severity of symptoms to be equivalent. Nevertheless, statistical analyses suggested that the younger surgical cohort perceived their QoL to be poorer, while pain levels were worse in the older injection cohort.