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Medical decision making in patients with knee pain, meniscal tear, and osteoarthritis
Arthritis Care and Research , 11/04/09

Suter LG et al. – Among individuals with degenerative meniscal tears and OA, easily obtainable clinical information can differentiate those who are more likely to benefit from APM.

• Two clinical (mechanical symptoms and pain pattern) and 2 magnetic resonance imaging (tear type and bone marrow lesions) indicators into 36 possible combinations and ranked each combination according to the likelihood of having primarily tear- versus OA-related pain in individuals ages 45-65 years with knee pain, OA, and meniscal tears

• Rank 1 (e.g., displaced tear, locking, increased pain, no bone marrow lesions) represented the highest likelihood of APM benefit; rank 36 (e.g., oblique tear, no mechanical symptoms, static pain, severe bone marrow lesions) represented the lowest likelihood of APM benefit
• Indeterminate middle ranks included individuals with mixed findings (i.e., 2 findings consistent with high and 2 with low likelihood of APM benefit)
• APM thresholds between ranks 17 and 23 resulted in >82% of the population receiving treatment producing the greatest possible IKDC improvement, with mean incremental gains in IKDC score of >24 points

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