Differences in pre-treatment symptoms of patients receiving injections or surgery to treat cartilage lesions of the knee: An ICRS 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 pre-treatment status of patients undergoing a knee injection or surgical intervention for cartilage lesions. Hypothesis: There will be no clinical difference in scores between the two cohorts.
Methods
Anonymous data from the International Cartilage Regeneration and Joint Preservation Society (ICRS) Registry were exported: Demographics, type of intervention, pre-treatment Knee Osteoarthritis Outcome Scores (KOOS) and Visual Analogue Scores (VAS). The required sample size was 273 per cohort. Statistical analyses compared the scores of each cohort (α = 0.05).
Results
1,578 patients were included (993 surgeries vs 585 injections). The surgical cohort were 30 years younger than the injection cohort (p<0.0001). 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<0.0001; p=0.04; p=0.001). KOOS QoL was poorer in the surgical cohort (p < 0.0001).
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.
Key Words
Registry; Cartilage injury; Knee Injections; Knee Surgery; Patient reported outcom