Degenerative Meniscus Lesions: An Expert Consensus Statement Using the Modified Delphi Technique
The purpose of this study was to perform an evidence-based, expert consensus survey using the Delphi panel methodology to develop recommendations for the treatment of degenerative meniscus tears. Twenty panel members were asked to respond to 10 open-ended questions in rounds 1 and 2. The results of...
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| Veröffentlicht in: | Arthroscopy 2020-02, Vol.36 (2), p.501-512 |
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| creator | Hohmann, Erik Angelo, Richard Arciero, Robert Bach, Bernard R. Cole, Brian Cote, Mark Farr, Jack Feller, Julian Gelbart, Brad Gomoll, Andreas Imhoff, Andreas LaPrade, Robert Mandelbaum, Bert R. Marx, Robert G. Monllau, Juan C. Noyes, Frank Parker, David Rodeo, Scott Sgaglione, Nicholas Shea, Kevin Shelbourne, Donald K. Yoshiya, Shinichi Glatt, Vaida Tetsworth, Kevin |
| description | The purpose of this study was to perform an evidence-based, expert consensus survey using the Delphi panel methodology to develop recommendations for the treatment of degenerative meniscus tears.
Twenty panel members were asked to respond to 10 open-ended questions in rounds 1 and 2. The results of the first 2 rounds served to develop a Likert-style questionnaire for round 3. In round 4, the panel members outside consensus were contacted and asked to either change their score in view of the group's response or argue their case. The level of agreement for round 4 was defined as 80%.
There was 100% agreement on the following items: insidious onset, physiological part of aging, tears often multiplanar, not all tears cause symptoms, outcomes depend on degree of osteoarthritis, obesity is a predictor of poor outcome, and younger patients ( |
| doi_str_mv | 10.1016/j.arthro.2019.08.014 |
| format | Article |
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Twenty panel members were asked to respond to 10 open-ended questions in rounds 1 and 2. The results of the first 2 rounds served to develop a Likert-style questionnaire for round 3. In round 4, the panel members outside consensus were contacted and asked to either change their score in view of the group's response or argue their case. The level of agreement for round 4 was defined as 80%.
There was 100% agreement on the following items: insidious onset, physiological part of aging, tears often multiplanar, not all tears cause symptoms, outcomes depend on degree of osteoarthritis, obesity is a predictor of poor outcome, and younger patients (<50 years) have better outcomes. There was between 90% and 100% agreement on the following items: tears are nontraumatic, radiographs should be weightbearing, initial treatment should be conservative, platelet-rich plasma is not a good option, repairable and peripheral tears should be repaired, microfracture is not a good option for chondral defects, the majority of patients obtain significant improvement and decrease in pain with surgery but results are variable, short-term symptoms have better outcomes, and malalignment and root tears have poor outcomes.
This consensus statement agreed that degenerative meniscus tears are a normal part of aging. Not all tears cause symptoms and, when symptomatic, they should initially be treated nonoperatively. Repairable tears should be repaired. The outcome of arthroscopic partial meniscectomy depends on the degree of osteoarthritis, the character of the meniscus lesion, the degree of loss of joint space, the amount of malalignment, and obesity. The majority of patients had significant improvement, but younger patients and patients with short-term symptoms have better outcomes.
Level V – expert opinion.</description><identifier>ISSN: 0749-8063</identifier><identifier>EISSN: 1526-3231</identifier><identifier>DOI: 10.1016/j.arthro.2019.08.014</identifier><identifier>PMID: 31901384</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><ispartof>Arthroscopy, 2020-02, Vol.36 (2), p.501-512</ispartof><rights>2019 Arthroscopy Association of North America</rights><rights>Copyright © 2019 Arthroscopy Association of North America. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-43f53d482dc8ae3b6e22022115d3a8ab283eca377c1334dc09a65b94b3e5c0593</citedby><cites>FETCH-LOGICAL-c362t-43f53d482dc8ae3b6e22022115d3a8ab283eca377c1334dc09a65b94b3e5c0593</cites><orcidid>0000-0002-9443-1455 ; 0000-0002-5313-0728 ; 0000-0002-4006-2113 ; 0000-0002-3069-4141</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0749806319307133$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31901384$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hohmann, Erik</creatorcontrib><creatorcontrib>Angelo, Richard</creatorcontrib><creatorcontrib>Arciero, Robert</creatorcontrib><creatorcontrib>Bach, Bernard R.</creatorcontrib><creatorcontrib>Cole, Brian</creatorcontrib><creatorcontrib>Cote, Mark</creatorcontrib><creatorcontrib>Farr, Jack</creatorcontrib><creatorcontrib>Feller, Julian</creatorcontrib><creatorcontrib>Gelbart, Brad</creatorcontrib><creatorcontrib>Gomoll, Andreas</creatorcontrib><creatorcontrib>Imhoff, Andreas</creatorcontrib><creatorcontrib>LaPrade, Robert</creatorcontrib><creatorcontrib>Mandelbaum, Bert R.</creatorcontrib><creatorcontrib>Marx, Robert G.</creatorcontrib><creatorcontrib>Monllau, Juan C.</creatorcontrib><creatorcontrib>Noyes, Frank</creatorcontrib><creatorcontrib>Parker, David</creatorcontrib><creatorcontrib>Rodeo, Scott</creatorcontrib><creatorcontrib>Sgaglione, Nicholas</creatorcontrib><creatorcontrib>Shea, Kevin</creatorcontrib><creatorcontrib>Shelbourne, Donald K.</creatorcontrib><creatorcontrib>Yoshiya, Shinichi</creatorcontrib><creatorcontrib>Glatt, Vaida</creatorcontrib><creatorcontrib>Tetsworth, Kevin</creatorcontrib><title>Degenerative Meniscus Lesions: An Expert Consensus Statement Using the Modified Delphi Technique</title><title>Arthroscopy</title><addtitle>Arthroscopy</addtitle><description>The purpose of this study was to perform an evidence-based, expert consensus survey using the Delphi panel methodology to develop recommendations for the treatment of degenerative meniscus tears.
Twenty panel members were asked to respond to 10 open-ended questions in rounds 1 and 2. The results of the first 2 rounds served to develop a Likert-style questionnaire for round 3. In round 4, the panel members outside consensus were contacted and asked to either change their score in view of the group's response or argue their case. The level of agreement for round 4 was defined as 80%.
There was 100% agreement on the following items: insidious onset, physiological part of aging, tears often multiplanar, not all tears cause symptoms, outcomes depend on degree of osteoarthritis, obesity is a predictor of poor outcome, and younger patients (<50 years) have better outcomes. There was between 90% and 100% agreement on the following items: tears are nontraumatic, radiographs should be weightbearing, initial treatment should be conservative, platelet-rich plasma is not a good option, repairable and peripheral tears should be repaired, microfracture is not a good option for chondral defects, the majority of patients obtain significant improvement and decrease in pain with surgery but results are variable, short-term symptoms have better outcomes, and malalignment and root tears have poor outcomes.
This consensus statement agreed that degenerative meniscus tears are a normal part of aging. Not all tears cause symptoms and, when symptomatic, they should initially be treated nonoperatively. Repairable tears should be repaired. The outcome of arthroscopic partial meniscectomy depends on the degree of osteoarthritis, the character of the meniscus lesion, the degree of loss of joint space, the amount of malalignment, and obesity. The majority of patients had significant improvement, but younger patients and patients with short-term symptoms have better outcomes.
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Twenty panel members were asked to respond to 10 open-ended questions in rounds 1 and 2. The results of the first 2 rounds served to develop a Likert-style questionnaire for round 3. In round 4, the panel members outside consensus were contacted and asked to either change their score in view of the group's response or argue their case. The level of agreement for round 4 was defined as 80%.
There was 100% agreement on the following items: insidious onset, physiological part of aging, tears often multiplanar, not all tears cause symptoms, outcomes depend on degree of osteoarthritis, obesity is a predictor of poor outcome, and younger patients (<50 years) have better outcomes. There was between 90% and 100% agreement on the following items: tears are nontraumatic, radiographs should be weightbearing, initial treatment should be conservative, platelet-rich plasma is not a good option, repairable and peripheral tears should be repaired, microfracture is not a good option for chondral defects, the majority of patients obtain significant improvement and decrease in pain with surgery but results are variable, short-term symptoms have better outcomes, and malalignment and root tears have poor outcomes.
This consensus statement agreed that degenerative meniscus tears are a normal part of aging. Not all tears cause symptoms and, when symptomatic, they should initially be treated nonoperatively. Repairable tears should be repaired. The outcome of arthroscopic partial meniscectomy depends on the degree of osteoarthritis, the character of the meniscus lesion, the degree of loss of joint space, the amount of malalignment, and obesity. The majority of patients had significant improvement, but younger patients and patients with short-term symptoms have better outcomes.
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| title | Degenerative Meniscus Lesions: An Expert Consensus Statement Using the Modified Delphi Technique |
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