Trial Outcomes & Findings for Prospective Trial of Arthroscopic Meniscectomy for Degenerative Meniscus Tears (NCT NCT01931735)

NCT ID: NCT01931735

Last Updated: 2018-11-21

Results Overview

Western Ontario Meniscal Evaluation Tool (WOMET) is a standardized and validated survey used to evaluate the pain and function of patients with a degenerative meniscal tear. The survey consists of 16 questions regarding physical symptoms, sports/recreation/work/lifestyle, and emotions. Each question is answered via a visual analog scale (VAS) of 0-100mm for a total score of 1600, where higher numbers are worse. The score is then transformed into a percentage, where 0 is the worst pain and functioning and 100% is no pain and fully functioning.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

27 participants

Primary outcome timeframe

one year post baseline

Results posted on

2018-11-21

Participant Flow

Participant milestones

Participant milestones
Measure
Randomized Meniscectomy
This group will have a partial meniscectomy Meniscectomy: Arthroscopic meniscectomy
Randomized Lavage
This group will have arthroscopy and lavage Arthroscopic Lavage: Arthroscopic Lavage
Standard of Care Meniscectomy Pre-Amendment
Pre-Amendment: surgeons determined standard of care option best benefited the patient.
Standard of Care Meniscectomy Post Amendment
Post Amendment: patients received a meniscectomy as a standard of care and were observed for 24-months post-operative.
Randomized Phase
STARTED
4
3
9
0
Randomized Phase
COMPLETED
2
1
4
0
Randomized Phase
NOT COMPLETED
2
2
5
0
Observational Non-Randomized Phase
STARTED
2
1
0
11
Observational Non-Randomized Phase
COMPLETED
2
1
0
9
Observational Non-Randomized Phase
NOT COMPLETED
0
0
0
2

Reasons for withdrawal

Reasons for withdrawal
Measure
Randomized Meniscectomy
This group will have a partial meniscectomy Meniscectomy: Arthroscopic meniscectomy
Randomized Lavage
This group will have arthroscopy and lavage Arthroscopic Lavage: Arthroscopic Lavage
Standard of Care Meniscectomy Pre-Amendment
Pre-Amendment: surgeons determined standard of care option best benefited the patient.
Standard of Care Meniscectomy Post Amendment
Post Amendment: patients received a meniscectomy as a standard of care and were observed for 24-months post-operative.
Randomized Phase
Lost to Follow-up
2
2
5
0
Observational Non-Randomized Phase
Adverse Event
0
0
0
1
Observational Non-Randomized Phase
Withdrawal by Subject
0
0
0
1

Baseline Characteristics

Prospective Trial of Arthroscopic Meniscectomy for Degenerative Meniscus Tears

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Randomized Meniscectomy
n=4 Participants
This group will have a partial meniscectomy Meniscectomy: Arthroscopic meniscectomy
Randomized Lavage
n=3 Participants
This group will have arthroscopy and lavage Arthroscopic Lavage: Arthroscopic Lavage
Standard of Care Meniscectomy Pre-Amendment
n=9 Participants
Pre-Amendment: surgeons determined standard of care option, meniscectomy, best benefited the patient.
Standard of Care Meniscectomy Post Amendment
n=11 Participants
Post Amendment: patients received a meniscectomy as a standard of care and were observed for 24-months post-operative.
Total
n=27 Participants
Total of all reporting groups
Age, Continuous
57.8 years
STANDARD_DEVIATION 9.5 • n=5 Participants
54.3 years
STANDARD_DEVIATION 3.5 • n=7 Participants
55.6 years
STANDARD_DEVIATION 7.7 • n=5 Participants
54.5 years
STANDARD_DEVIATION 10.8 • n=4 Participants
55.3 years
STANDARD_DEVIATION 8.7 • n=21 Participants
Sex: Female, Male
Female
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
1 Participants
n=21 Participants
Sex: Female, Male
Male
4 Participants
n=5 Participants
2 Participants
n=7 Participants
9 Participants
n=5 Participants
11 Participants
n=4 Participants
26 Participants
n=21 Participants
Race/Ethnicity, Customized
Caucasian
1 Participants
n=5 Participants
2 Participants
n=7 Participants
6 Participants
n=5 Participants
5 Participants
n=4 Participants
14 Participants
n=21 Participants
Race/Ethnicity, Customized
Hispanic
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
2 Participants
n=4 Participants
4 Participants
n=21 Participants
Race/Ethnicity, Customized
Unknown
2 Participants
n=5 Participants
0 Participants
n=7 Participants
2 Participants
n=5 Participants
0 Participants
n=4 Participants
4 Participants
n=21 Participants
Race/Ethnicity, Customized
African American
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
3 Participants
n=4 Participants
4 Participants
n=21 Participants
Race/Ethnicity, Customized
Other
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
1 Participants
n=21 Participants
Region of Enrollment
United States
4 participants
n=5 Participants
3 participants
n=7 Participants
9 participants
n=5 Participants
11 participants
n=4 Participants
27 participants
n=21 Participants
Total WOMET Score
44.8 units on a scale
STANDARD_DEVIATION 31.5 • n=5 Participants
45.2 units on a scale
STANDARD_DEVIATION 9.1 • n=7 Participants
27.5 units on a scale
STANDARD_DEVIATION 12.2 • n=5 Participants
33.1 units on a scale
STANDARD_DEVIATION 22.5 • n=4 Participants
34.2 units on a scale
STANDARD_DEVIATION 20.2 • n=21 Participants
KOOS Pain Score
29.6 units on a scale
STANDARD_DEVIATION 8.5 • n=5 Participants
47.2 units on a scale
STANDARD_DEVIATION 11.78 • n=7 Participants
40.1 units on a scale
STANDARD_DEVIATION 12.7 • n=5 Participants
42.9 units on a scale
STANDARD_DEVIATION 17.9 • n=4 Participants
40.7 units on a scale
STANDARD_DEVIATION 14.8 • n=21 Participants

PRIMARY outcome

Timeframe: one year post baseline

Population: Randomize Meniscectomy: 2 lost to follow-up. Randomized Lavage: 2 lost to follow-up. Standard of Care Meniscectomy Pre-Amendment: 5 lost to follow-up. Standard of Care Meniscectomy Post Amendment: 1 withdrew participation.

Western Ontario Meniscal Evaluation Tool (WOMET) is a standardized and validated survey used to evaluate the pain and function of patients with a degenerative meniscal tear. The survey consists of 16 questions regarding physical symptoms, sports/recreation/work/lifestyle, and emotions. Each question is answered via a visual analog scale (VAS) of 0-100mm for a total score of 1600, where higher numbers are worse. The score is then transformed into a percentage, where 0 is the worst pain and functioning and 100% is no pain and fully functioning.

Outcome measures

Outcome measures
Measure
Randomized Meniscectomy
n=2 Participants
This group will have a partial meniscectomy Meniscectomy: Arthroscopic meniscectomy
Randomized Lavage
n=1 Participants
This group will have arthroscopy and lavage Arthroscopic Lavage: Arthroscopic Lavage
Standard of Care Meniscectomy Pre-Amendment
n=4 Participants
Pre-Amendment: surgeons determined standard of care option, meniscectomy, best benefited the patient.
Standard of Care Meniscectomy Post Amendment
n=10 Participants
Post Amendment: patients received a meniscectomy as a standard of care and were observed for 24-months post-operative.
WOMET Score
57.5 units on a scale
Standard Deviation 42.2
99.4 units on a scale
37.0 units on a scale
Standard Deviation 18.1
63.9 units on a scale
Standard Deviation 21.9

PRIMARY outcome

Timeframe: two years post baseline

Population: Randomize meniscectomy: 2 lost to follow-up. Randomized Lavage: 2 lost to follow-up. Standard of care meniscectomy pre-amendment: not in protocol to follow subjects 2 years post baseline. Standard of care meniscectomy post-amendment: 1 withdraw, 1 adverse event.

Western Ontario Meniscal Evaluation Tool (WOMET) is a standardized and validated survey used to evaluate the pain and function of patients with a degenerative meniscal tear. The survey consists of 16 questions regarding physical symptoms, sports/recreation/work/lifestyle, and emotions. Each question is answered via a visual analog scale (VAS) of 0-100mm for a total score of 1600, where higher numbers are worse. The score is then transformed into a percentage, where 0 is the worst pain and functioning and 100% is no pain and fully functioning.

Outcome measures

Outcome measures
Measure
Randomized Meniscectomy
n=2 Participants
This group will have a partial meniscectomy Meniscectomy: Arthroscopic meniscectomy
Randomized Lavage
n=1 Participants
This group will have arthroscopy and lavage Arthroscopic Lavage: Arthroscopic Lavage
Standard of Care Meniscectomy Pre-Amendment
Pre-Amendment: surgeons determined standard of care option, meniscectomy, best benefited the patient.
Standard of Care Meniscectomy Post Amendment
n=9 Participants
Post Amendment: patients received a meniscectomy as a standard of care and were observed for 24-months post-operative.
WOMET Score
49.0 units on a scale
Standard Deviation 50.0
99.6 units on a scale
57.4 units on a scale
Standard Deviation 27.9

PRIMARY outcome

Timeframe: Two year post baseline

Population: Standard of Care Meniscectomy Pre-Amendment group were not assessed for this outcome. Randomized Meniscectomy: 1 was not assessed due to relocation, 2 were lost to follow-up. Randomized lavage: 2 participants were lost to follow-up. Standard of Care Meniscectomy Post Amendment: 1 had an adverse event, 1 participant withdrew from the study.

Knee adduction moment describes the medial/lateral load distribution of the knee measured while walking in a gait laboratory. Before normalization to account for size, the knee adduction moment is expressed in Nm. However, to account for different sized people, the knee adduction moment is transformed and expressed in percentage of body weight times height (%BW\*ht). Higher knee adduction moments have been linked to more severe osteoarthritis (OA).

Outcome measures

Outcome measures
Measure
Randomized Meniscectomy
n=1 Participants
This group will have a partial meniscectomy Meniscectomy: Arthroscopic meniscectomy
Randomized Lavage
n=1 Participants
This group will have arthroscopy and lavage Arthroscopic Lavage: Arthroscopic Lavage
Standard of Care Meniscectomy Pre-Amendment
Pre-Amendment: surgeons determined standard of care option, meniscectomy, best benefited the patient.
Standard of Care Meniscectomy Post Amendment
n=9 Participants
Post Amendment: patients received a meniscectomy as a standard of care and were observed for 24-months post-operative.
Gait Knee Adduction Moment
-3.32 percentage of body weight times height
-5.40 percentage of body weight times height
-2.15 percentage of body weight times height
Standard Deviation 0.51

PRIMARY outcome

Timeframe: Two years post baseline

Population: Standard of Care Meniscectomy Pre-Amendment group were not assessed for this outcome. Randomized Meniscectomy: 1 was not assessed due to relocation, 2 were lost to follow-up. Randomized lavage: 2 participants were lost to follow-up. Standard of Care Meniscectomy Post Amendment: 1 had an adverse event, 1 participant withdrew from the study.

Degree of external tibial rotation averaged over the stance phase of gait.

Outcome measures

Outcome measures
Measure
Randomized Meniscectomy
n=1 Participants
This group will have a partial meniscectomy Meniscectomy: Arthroscopic meniscectomy
Randomized Lavage
n=1 Participants
This group will have arthroscopy and lavage Arthroscopic Lavage: Arthroscopic Lavage
Standard of Care Meniscectomy Pre-Amendment
Pre-Amendment: surgeons determined standard of care option, meniscectomy, best benefited the patient.
Standard of Care Meniscectomy Post Amendment
n=8 Participants
Post Amendment: patients received a meniscectomy as a standard of care and were observed for 24-months post-operative.
Average Rotation During Stance
12.5 degrees
8.2 degrees
8.9 degrees
Standard Deviation 4.7

SECONDARY outcome

Timeframe: two years post baseline

Population: Randomize meniscectomy: 2 lost to follow-up. Randomized Lavage: 2 lost to follow-up. Standard of care meniscectomy pre-amendment: not in protocol to follow subjects 2 years post baseline. Standard of care meniscectomy post-amendment: 1 withdraw, 1 adverse event.

Knee injury and Osteoarthritis Outcome Score (KOOS) is a standardized and validated survey used to evaluate the condition of osteoarthritis of the knee. The KOOS Pain scale consists of 9 questions, with each response valued on an ordinal scale of 0-4, and with at total score of 36. Higher numbers indicate more symptoms and physical disabilities. The score is then transformed into a percentage, where 0% is the worst pain and 100% is no pain.

Outcome measures

Outcome measures
Measure
Randomized Meniscectomy
n=2 Participants
This group will have a partial meniscectomy Meniscectomy: Arthroscopic meniscectomy
Randomized Lavage
n=1 Participants
This group will have arthroscopy and lavage Arthroscopic Lavage: Arthroscopic Lavage
Standard of Care Meniscectomy Pre-Amendment
Pre-Amendment: surgeons determined standard of care option, meniscectomy, best benefited the patient.
Standard of Care Meniscectomy Post Amendment
n=9 Participants
Post Amendment: patients received a meniscectomy as a standard of care and were observed for 24-months post-operative.
KOOS Pain Score
48.6 units on a scale
Standard Deviation 41.2
100 units on a scale
68.5 units on a scale
Standard Deviation 26.3

SECONDARY outcome

Timeframe: one year post baseline

Population: Randomize meniscectomy: 2 lost to follow-up. Randomized Lavage: 2 lost to follow-up. Standard of care meniscectomy pre-amendment: 5 lost to follow-up. Standard of care meniscectomy post-amendment: 1 withdraw

Knee injury and Osteoarthritis Outcome Score (KOOS) is a standardized and validated survey used to evaluate the condition of osteoarthritis of the knee. The KOOS Pain scale consists of 9 questions, with each response valued on an ordinal scale of 0-4, and with at total score of 36. Higher numbers indicate more symptoms and physical disabilities. The score is then transformed into a percentage, where 0% is the worst pain and 100% is no pain.

Outcome measures

Outcome measures
Measure
Randomized Meniscectomy
n=2 Participants
This group will have a partial meniscectomy Meniscectomy: Arthroscopic meniscectomy
Randomized Lavage
n=1 Participants
This group will have arthroscopy and lavage Arthroscopic Lavage: Arthroscopic Lavage
Standard of Care Meniscectomy Pre-Amendment
n=4 Participants
Pre-Amendment: surgeons determined standard of care option, meniscectomy, best benefited the patient.
Standard of Care Meniscectomy Post Amendment
n=10 Participants
Post Amendment: patients received a meniscectomy as a standard of care and were observed for 24-months post-operative.
KOOS Pain Score
38.9 units on a scale
Standard Deviation 39.3
100 units on a scale
36.8 units on a scale
Standard Deviation 15.4
66.7 units on a scale
Standard Deviation 16.9

SECONDARY outcome

Timeframe: Baseline

Population: No participants were assessed for this measure (data were not collected).

Tumor necrosis factor-alpha (TNFa) is a pro-inflammatory cytokine that has been linked to the presence of radiographic signs of osteoarthritis (OA), cartilage volume loss over time, increased disease severity, and risk of OA progression. Elevated presence of TNFa can indicate more risk for OA. The unit of measure is pg/mL.

Outcome measures

Outcome data not reported

Adverse Events

Randomized Meniscectomy

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Randomized Lavage

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Standard of Care Meniscectomy Pre-Amendment

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Standard of Care Meniscectomy Post Amendment

Serious events: 2 serious events
Other events: 1 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Randomized Meniscectomy
n=4 participants at risk
This group will have a partial meniscectomy Meniscectomy: Arthroscopic meniscectomy
Randomized Lavage
n=3 participants at risk
This group will have arthroscopy and lavage Arthroscopic Lavage: Arthroscopic Lavage
Standard of Care Meniscectomy Pre-Amendment
n=9 participants at risk
Pre-Amendment: surgeons determined standard of care option, meniscectomy, best benefited the patient.
Standard of Care Meniscectomy Post Amendment
n=11 participants at risk
Post Amendment: patients received a meniscectomy as a standard of care and were observed for 24-months post-operative.
Injury, poisoning and procedural complications
Car accident
0.00%
0/4 • 2 years
0.00%
0/3 • 2 years
0.00%
0/9 • 2 years
9.1%
1/11 • Number of events 1 • 2 years
Endocrine disorders
Diabetic Ulcer
0.00%
0/4 • 2 years
0.00%
0/3 • 2 years
0.00%
0/9 • 2 years
9.1%
1/11 • Number of events 1 • 2 years

Other adverse events

Other adverse events
Measure
Randomized Meniscectomy
n=4 participants at risk
This group will have a partial meniscectomy Meniscectomy: Arthroscopic meniscectomy
Randomized Lavage
n=3 participants at risk
This group will have arthroscopy and lavage Arthroscopic Lavage: Arthroscopic Lavage
Standard of Care Meniscectomy Pre-Amendment
n=9 participants at risk
Pre-Amendment: surgeons determined standard of care option, meniscectomy, best benefited the patient.
Standard of Care Meniscectomy Post Amendment
n=11 participants at risk
Post Amendment: patients received a meniscectomy as a standard of care and were observed for 24-months post-operative.
Immune system disorders
Rheumatoid Arthritis
0.00%
0/4 • 2 years
0.00%
0/3 • 2 years
0.00%
0/9 • 2 years
9.1%
1/11 • Number of events 1 • 2 years

Additional Information

Jessica Asay

VA Palo Alto Research

Phone: 650-493-5000

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place