A Longer Duration from Injury to Surgery is Associated with Preoperative Deterioration of an Isolated Meniscal Tear in Patients Aged 40 Years or Older

Abstract Background: It remains unclear what percentage of isolated meniscal tears deteriorates before surgery, especially in older patients. We aimed to evaluate the preoperative deterioration of an isolated meniscal tear in patients aged 40 years or older, and whether time from injury to surgery is associated with worsening of a meniscal tear.Methods: Patients aged 40 years or older who underwent arthroscopic surgery for isolated meniscal tear between 2014 and 2019 were retrospectively reviewed. The diagnostic magnetic resonance imaging (MRI) findings and arthroscopic findings were compared to evaluate the deterioration of meniscal tears. Predictors of the development of meniscal tears; patient demographic factors, duration from injury to surgery (injury to MRI and MRI to surgery), and image findings were assessed. Results: A total of 58 patients (58 knees) were included (mean age, 55.9 ± 8.5 years; male/female, 31/27). An isolated meniscal tear deteriorated in 28 (48.3%). In comparison of patients with and without deteriorated meniscal tear, significant differences were found in the MRI grade of meniscal tear (p = 0.03), duration from injury to MRI (164.2 ± 167.9 vs. 45.2 ± 48.7 days, p < 0.001), and from MRI to surgery (148.8 ± 91.1 vs. 67.6 ± 56.7 days, p < 0.001). A multivariate regression analysis showed that the duration from injury to MRI (odds ratio [OR], 1.03; p < 0.001) and from MRI to surgery (OR, 1.02; p < 0.001) were independent predictors of worsening of a meniscal tear. Conclusions: Approximately 50% of isolated meniscal tears deteriorated preoperatively in patients aged 40 years or older. The duration from injury to MRI and from MRI to surgery were independent predictors of the preoperative worsening of an isolated meniscal tear in this cohort.