1000 Section - Predictive factors of clinical good response 6 months after US-guided meniscal wall infiltration in patients with degenerative meniscal lesions.

Degenerative meniscal lesion is a frequent reason for consultation, occurring both in young active individuals and in older patients. Surgery is sometimes indicated, but many cases can be managed conservatively. The management of stable DML is always a challenge due to the lack of universal consensus and evidence. Corticosteroid injections targeting the meniscal wall are now part of conservative treatment strategies, although the factors predicting their clinical effectiveness remain poorly defined.
The primary objective was to identify clinical, functional, and imaging factors associated with a good 6-month response to a corticosteroid injection at the meniscal wall in patients with degenerative meniscal lesions.


Design:

This was a prospective, observational, single-center study including 78 patients presenting with knee pain along the femorotibial joint line and an MRI-confirmed meniscal lesion. We assessed ultrasound-guided corticosteroids meniscal-wall infiltration as a conservative therapy for symptomatic DML and we searched for associated factors of good response. A good responder was defined as a patient showing a significant reduction in pain (VAS) ( > 60%).
Our hypothesis is that these injections will contribute to improve knee pain related DML.



Results:

At 6 months, 46% of patients (36/78) were classified as good responders. Regular sports activity (OR = 3.5; 95% CI [0,9997 - 8,416]; p = 0.05) and the presence of an osteomeniscal impingement (MRI) (OR = 2.9; 95% CI [1,2737 - 9,683]; p = 0.015) were significantly associated with a good response. Adverse effects were rare (3%) and mild.


Conclusion:

Corticosteroids injection at the meniscal wall is an effective and well-tolerated therapeutic approach for patients with degenerative meniscal lesions. Certain factors may help guide the selection of patients most likely to respond favorably to treatment. Regular physical activity and the presence of an osteomeniscal impingement (MRI) appear to be independently associated with a good 6-month response to the injection.