Abstract
Background
Meniscus tears are common, occurring acutely during sports or as degenerative tears with aging. Limited information exists about the public’s understanding of these injuries and their management.
Hypothesis/Purpose
This study aimed to evaluate the public’s baseline understanding of meniscus tear management and assess the effectiveness of an educational intervention to improve their understanding.
Study design
Level III, Cross-Sectional Study.
Methods
A 33-question survey on meniscus anatomy, injury risk, diagnosis, treatment, and surgical expectations was distributed online to adults aged 18+ over 5 months from the beginning of July. An educational video and handout were provided to improve baseline knowledge. Data analysis included descriptive statistics, ANOVA, McNemar’s test, and a paired t-test to measure pre- and post-intervention changes.
Results
Baseline surveys from 245 participants showed 66.9% were women, 69.4% were aged 18–29, and 63.7% were white. 46.1% held a bachelor’s degree, and 90.2% had limited knowledge of meniscus tears. 76% believed surgery was necessary, 84% thought degenerative tears were repairable, and 65% didn’t understand the link to osteoarthritis. Most expected over 3 months for recovery. Higher scores were associated with male gender, healthcare experience, and prior knowledge (p < 0.05). Post-intervention, correct responses rose from 45.3% to 75% (p < 0.001) among 118 participants.
Conclusion
Significant misconceptions about meniscus tears were identified. An educational intervention notably improved knowledge of meniscus anatomy, its link to osteoarthritis, and treatment options. This underscores the importance of education in aligning patient expectations with current medical practices to enhance care quality.
Keywords: Meniscus, Tear, Knee, Perception, Public, Sports
1. Introduction
Meniscus tears are one of the most common orthopaedic injuries, with a prevalence of 12–14% and an incidence of 60 cases for every 100,000 people in the general population.1 Chronic degenerative tears account for 30% of meniscus tears affecting older adults, most frequently occurring in men aged 41–50 and females aged 61–70.2 Acute meniscus tears often occur during activity or sports-related trauma.
The menisci are C-shaped, fibrocartilaginous structures in the tibiofemoral joint that play a crucial role in stabilizing and cushioning during weight-bearing activities.3 Activities involving forceful twisting and pivoting increase the chance of tearing the meniscus, especially in contact or dynamic sports.4 In a study of 1515 meniscectomies, 81% of the tears were in the medial meniscus.5 Among the 505 sports-related injuries, football accounted for the most cases, followed by basketball, wrestling, baseball, skiing, soccer, rugby, lacrosse, and other miscellaneous sports.5 Obesity and age-related wear and tear are important risk factors for degenerative tears.1 Degenerative meniscus tears are often initially managed non-surgically with rest, ice, non-steroidal anti-inflammatory drugs (NSAIDs), physical therapy, and possibly corticosteroid injections.6 Surgery may be considered if mechanical symptoms persist despite conservative measures. According to a 2022 study, 500,000 arthroscopic partial meniscectomies (APM) are performed yearly in the United States, making it one of the most common orthopaedic procedures.7 In a 2018 study conducted in the state of Florida, there were 291 APMs per 100,000 people.8
Despite the widespread prevalence and impact of meniscus tears, there is a notable knowledge gap regarding the public’s awareness of this condition. These misconceptions could lead to unrealistic expectations, which in turn may adversely impact the patient-provider relationship and decrease patient satisfaction. We aim to enhance patient outcomes by developing better educational tactics based on a clearer understanding of the public’s baseline knowledge regarding meniscus tears. The purpose of this study is to determine the existing level of public knowledge regarding meniscus tears and pinpoint knowledge gaps that can be addressed to help patients make better judgments about the prevention, treatment, and rehabilitation of meniscus injuries. We hypothesize that the public’s knowledge regarding meniscus tears, including details related to anatomy and function, diagnosis, treatment, and outcomes will be low, with less than 50% of correct responses. Secondarily, we hypothesize that a literature-based educational intervention will statistically improve baseline knowledge.
2. Methods
This cross-sectional study was approved by our Institutional Review Board (IRB# 231240). We designed a comprehensive 33-question online survey to evaluate the diverse aspects of the public’s knowledge regarding meniscus tears. Item generation, item reduction, questionnaire formatting, and pretesting were performed according to a standardized method.9 The questionnaire was crafted with language and complexity suitable for an 8th-grade reading level across all its components.10 Questions were composed of multiple-choice options, “yes” or “no”, “true” or “false”, and visual analog scale (VAS, rated on a scale of 0–10, with 10 reflecting the worst possible pain). An option of “unsure” was added to all applicable questions. The data was gathered electronically using the Research Electronic Data Capture (REDCap) database, a secure web-based platform supporting data capture for research studies.11
The survey questions were created by consensus after an extensive literature review (Table 1). We aimed to gather insights into various aspects of participants' knowledge, experiences, and perceptions related to meniscus tears. The questionnaire included participant demographics such as age, sex, race/ethnicity, highest education level, medical profession involvement, whether they or someone they knew had a history of meniscus tear diagnosis, and self-assessment of understanding regarding meniscus tears. Subsequent questions focused on anatomy and function, injury risk factors, diagnosis, treatment options for both acute and degenerative injuries, post-operative expectations following partial meniscectomy, and perceived surgical risks and outcomes. Within the 33-question survey, 7 questions were structured as factual, denoting a single correct response in accordance with contemporary orthopaedic literature.3,12, 13, 14, 15 The remaining 26 questions were intentionally designed to elicit diverse responses, aiming to explore and gauge participants' perceptions rather than seeking a single correct answer.
Table 1.
Categories of question.
| Question category: | Number of questions: |
|---|---|
| Demographics | 7 |
| Anatomy & Function | 4 |
| Risk Factors | 2 |
| Diagnosis | 2 |
| Treatment Options | 16 |
| Post-Opertative Expectations | 4 |
| Surgical Risks | 3 |
| Surgical Outcomes | 2 |
After completing the pre-intervention questionnaire, participants were presented with a 4-min informational video presentation encompassing a comprehensive review of the posed questions with literature-based information aligned with current orthopaedic practices.1,6,12,14,16 Additionally, a written transcript of the presentation was provided for optional reading. Subsequently, the post-intervention assessment was administered immediately following the educational intervention to evaluate the level of increased understanding. Comprising 26 questions, the post-intervention questionnaire mirrored the content of the pre-intervention questionnaire, excluding the demographics section.
The survey was made available on July 27th, 2023, and was open for 5 months. The survey was posted on various social media platforms (Facebook, Instagram, LinkedIn) and subreddit pages (r/nba, r/football, r/nfl, r/basketbal, r/kneeinjuries, r/samplesize, r/meniscusinjuries, r/sportsmedicine, r/orthopedics, and r/physicaltherapy) (refer to Appendix 1B). Participation in the survey was voluntary, and no compensation was provided for completion. The criteria for inclusion were English-speaking and individuals aged 18 years or older.
2.1. Statistical analysis
The pre-intervention analyses were conducted considering the full completion of all pre-intervention questions, regardless of post-intervention status (n = 245). A bivariate comparison was applied to evaluate the correlation between correct responses to the 7 factual questions and participant characteristics derived from their answers in the demographics section of the pre-intervention survey. Post-hoc analyses were conducted to discern significant differences among categories in cases where more than two groups were present. An ANOVA test was utilized to examine mean differences in the number of correct responses across various participant characteristics groups. McNemar’s test was performed to assess if there were significant differences in the proportion of participants who answered each question correctly in both the pre- and post-intervention assessments. Lastly, a paired t-test was performed to assess if there were changes in the mean responses of opinion-type items from pre-to post-intervention. Comparisons between pre-intervention and post-intervention data were conducted for participants who successfully completed all items in both the pre-intervention and post-intervention assessments (n = 118).
3. Results
A total of 297 participants enrolled, confirming their age and acknowledged voluntary participation. The pre-test was completed by 245 (82.5%) subjects and the post-intervention survey was completed by 118 (39.7%) participants.
3.1. Subject demographics
Participant demographics are found in Table 2. Within this cohort, 170 participants were aged 18–29 (69.4%), 63.7% were White, and the majority held at least a bachelor’s degree (n = 113, 46.1%), or a master’s degree (n = 62, 25.3%). Additionally, 52 individuals (21.2%) reported having a medical background. Regarding experiences with meniscus-related conditions, 50 participants (20.4%) reported a personal diagnosis, and 49 (20.0%) were familiar with someone who had a meniscus tear. Exploring their self-reported knowledge, 143 participants (58.4%) indicated “some” understanding of the meniscus, with only 24 (10%) self-identifying as “very knowledgeable.” Conversely, 78 participants (31.8%) admitted to having no knowledge of the meniscus at all.
Table 2.
Participant characteristics (Pre-intervention only) (n = 245).
| n | % | |
|---|---|---|
| Age group | ||
| 18-29 | 170 | 69.4 |
| 30-39 | 37 | 15.1 |
| 40-49 | 22 | 9.0 |
| 50-59 | 10 | 4.1 |
| 60+ | 6 | 2.4 |
| Gender | ||
| Male | 79 | 32.2 |
| Female | 164 | 66.9 |
| Prefer not to answer | 2 | 0.8 |
| Race/Ethnicity | ||
| White | 156 | 63.7 |
| African American or Black | 11 | 4.5 |
| Hispanic or Latino | 12 | 4.9 |
| Asian | 47 | 19.2 |
| Other | 19 | 7.8 |
| Education | ||
| High school or GED | 40 | 16.3 |
| Associates degree | 24 | 9.8 |
| Bachelors degree | 113 | 46.1 |
| Masters degree | 62 | 25.3 |
| Doctoral degree | 6 | 2.4 |
| Do you or did you work in a medical profession? | ||
| No | 193 | 78.8 |
| Yes | 52 | 21.2 |
| Have you or someone you know ever been diagnosed with a meniscus tear? | ||
| Yes, myself | 50 | 20.4 |
| Yes, someone I know | 49 | 20.0 |
| No | 146 | 59.6 |
| How would you rate your understanding of the meniscus? | ||
| No knowledge | 78 | 31.8 |
| Some knowledge | 143 | 58.4 |
| Very Knowledgeable | 24 | 9.8 |
3.2. Anatomy & function
Table 3 highlights the reported answers in the initial survey. A significant majority of participants (n = 140, 57.1%) inaccurately categorized the meniscus as muscle, bone, tendon, nerve, blood vessel, or expressed uncertainty. However, 203 participants (82.9%) correctly identified the meniscus as being in the knee, and 117 individuals (47.8%) correctly identified the presence of 2 menisci in each knee.
Table 3.
Pre-intervention summary (n = 245).
| Individual items | n | % |
|---|---|---|
| The Meniscus: | ||
| The Meniscus is a: | ||
| Incorrect | 140 | 57.1 |
| Correct = Cartilage | 105 | 42.9 |
| Location of the Meniscus: | ||
| Incorrect | 42 | 17.1 |
| Correct = Knee | 203 | 82.9 |
| Number of menisci in each knee: | ||
| Incorrect | 128 | 52.2 |
| Correct = 2 | 117 | 47.8 |
| How Meniscus tears develop: | ||
| Meniscus tears often result of: | ||
| A single injury (twist, kneeling, squat) | 29 | 11.8 |
| Wear and tear over time | 23 | 9.4 |
| Either (single injury or wear and tear) | 155 | 63.3 |
| Unsure | 38 | 15.5 |
| Are meniscus tears assoc. w/osteoarthritis? | ||
| Incorrect | 160 | 65.3 |
| Correct = Yes | 85 | 34.7 |
| Diagnosing Meniscus tears: | ||
| How effective is the physical exam in diagnosing a meniscus tear? | ||
| Not effective | 20 | 8.2 |
| Somewhat effective | 99 | 40.4 |
| Very effective | 52 | 21.2 |
| Unsure | 74 | 30.2 |
| Most definitive imaging test to diagnose a meniscus tear: | ||
| Incorrect | 130 | 53.1 |
| Correct = MRI | 115 | 46.9 |
| Treatment and recovery: | ||
| Meniscus tears can reliably heal on their own: | ||
| FALSE | 165 | 67.3 |
| TRUE | 80 | 32.7 |
| Most meniscus tears can be repaired by surgery. | ||
| FALSE | 39 | 15.9 |
| TRUE | 206 | 84.1 |
| Most meniscus injuries require surgery at some point. | ||
| FALSE | 58 | 23.7 |
| TRUE | 187 | 76.3 |
| What do you expect the pain from a meniscus surgery to be? (0–10) | ||
| Mean: 6.32 | ||
| Median: 7 | ||
| Mode: 7 (24.9%) | ||
3.3. Epidemiology
The predominant belief among participants was that a meniscus tear results from either a single injury, such as twisting or squatting, or from gradual wear and tear over time to the knee (n = 155, 63.3%). Specifically, 29 participants (11.8%) only attributed meniscus tears to a single injury, while 23 participants (9.4%) believed they only result from wear and tear over time. Interestingly, 85 participants (34.7%) correctly associated meniscus tears with the potential development of osteoarthritis, whereas 160 participants (65.3%) did not make this association.
3.4. Diagnosis and treatment
Most participants held the view that a physical examination is “somewhat effective” (n = 99, 40.4%) or “very effective” (n = 52, 21.2%) at diagnosing a meniscal injury. For the diagnosis of a meniscus tear, 115 participants (46.9%) identified that an MRI is the imaging modality of choice for diagnosis, while 130 participants opted for other imaging modalities such as X-ray, CT scan, ultrasound, or expressed uncertainty.
When inquired about the possibility of meniscus tears healing on their own, the majority responded with “false” (n = 165, 67.3%). When queried about the potential for surgical repair, 206 participants (84.1%) thought most meniscus tears could be repaired with surgery (as opposed to debridement). Additionally, 187 participants (76.3%) believed that surgery is needed for most meniscus tears. The average expected post-operative pain on a VAS following meniscus surgery was 6.3. The median and mode for pain scores were both 7. The perceived effectiveness of treatments for acute injury, ordered from most to least effective, was: surgery, physical therapy, anti-inflammatory medications, biological injections, rest and ice, and steroid injections. In the context of degenerative tears, the perceived sequence of effectiveness from most to least was: surgery, physical therapy, biological injections, steroid injections, anti-inflammatory medications, and rest and ice.
3.5. Post-operative expectations
Participants' perceptions of return to activity following arthroscopic partial meniscectomy for acute tears are illustrated in Fig. 1. Less than half of participants expected to be standing (42%, n = 103) and walking (19%, n = 47) within 1–2 weeks post-surgery. Return to running and sports was estimated to take ≥3 months by the majority of participants.
Fig. 1.
Activites after partial meniscectomy.
3.6. Surgical risks and outcomes
Nearly half of the respondents (n = 124, 50.6%) did not believe that surgery would consistently alleviate pain. Regarding the return to normal activities post-surgery, the majority of participants (n = 155, 63.3%) believed it would occur “often”. Participants rated the risks of infection, arthritis, and blood clots on a scale from 0 to 100. The average perceived risk of post-surgery infection was 41.6% ± 25.0%, closely matching the risk estimate for blood clots at 41.7% ± 25.0%. Additionally, participants perceived the risk of developing arthritis post-surgery to be approximately 46.7% ± 23.1%.
3.7. Statistical associations
An ANOVA comparison was utilized to investigate the relationship between patient characteristics and correct responses for the seven scoreable items (Table 4). Notably, participants aged 60 years and older and males scored higher (p < 0.001). Those working in the medical profession and those self-reporting a high understanding of meniscus tear scored higher as well (p < 0.001). Regarding personal history of meniscus injury, those who had a tear themselves scored the highest compared to those with no exposure, followed by those who knew someone with a meniscus tear (p < 0.001). Education level was not associated with a higher number of correct responses (p = 0.23).
Table 4.
ANOVA of participant characteristics and number pre-intervention responses correct (n = 245).
| Mean | SD | p-value | |
|---|---|---|---|
| Age Group: | <0.001 | ||
| 18–29 | 2.9 | 1.7 | |
| 30–39 | 3.7 | 1.8 | |
| 40–49 | 4.2 | 1.9 | |
| 50–59 | 4.2 | 2.1 | |
| 60+ | 4.8 | 1.6 | |
| Age Group: Condensed | <0.001 | ||
| 18–29 | 2.9 | 1.7 | |
| ≥30 | 4.0 | 1.9 | |
| Gender: | 0.042 | ||
| Male | 3.6 | 1.8 | |
| Female | 3.1 | 1.8 | |
| Education Level: | 0.23 | ||
| High school/GED or Assoc. degree | 3.0 | 1.9 | |
| Bachelors or higher | 3.3 | 1.8 | |
| Do you or did you work in a medical profession? | <0.001 | ||
| No | 3.0 | 1.8 | |
| Yes | 4.3 | 1.7 | |
| Have you or someone you know ever been diagnosed with a meniscus tear? | <0.001 | ||
| Yes, myself | 5.0 | 1.5 | |
| Yes, someone I know | 3.9 | 1.5 | |
| No | 2.4 | 1.5 | |
| Have you or someone you know ever been diagnosed with a meniscus tear? Condensed | <0.001 | ||
| No | 2.4 | 1.5 | |
| Yes | 4.5 | 1.6 | |
| How would you rate your understanding of the meniscus? | <0.001 | ||
| No knowledge | 1.7 | 1.1 | |
| Some knowledge | 3.8 | 1.5 | |
| Very Knowledgeable | 5.1 | 1.7 |
3.8. Pre-intervention and post-intervention correct responses
McNemar’s test was utilized to examine whether there were significant differences in the proportion of participants providing correct answers for each of the seven scoreable questions in both the pre-intervention and post-intervention surveys (Table 5). Before the intervention, 61 participants incorrectly associated meniscus tears with osteoarthritis in the pre-survey. This misconception was corrected after the intervention, as evidenced by the post-survey results. Significant positive changes after the intervention were noted in every question (p < 0.01).
Table 5.
McNemar’s test.
| Post-intervention |
|||
|---|---|---|---|
| Incorrect |
Correct |
||
| Pre-intervention | n | n | p-value |
| The Meniscus is a: | <0.001 | ||
| Incorrect | 16 | 52 | |
| Correct = Cartilage | 4 | 46 | |
| Location of the Meniscus: | |||
| Incorrect | 7 | 17 | |
| Correct = Knee | 0 | 94 | |
| Number of menisci in each knee: | <0.001 | ||
| Incorrect | 24 | 43 | |
| Correct = 2 | 2 | 49 | |
| Are meniscus tears assoc. w/osteoarthritis? | <0.001 | ||
| Incorrect | 21 | 61 | |
| Correct = Yes | 2 | 34 | |
| Most definitive imaging test to diagnose a meniscus tear: | <0.001 | ||
| Incorrect | 28 | 37 | |
| Correct = MRI | 3 | 50 | |
| Walking Timeline: | <0.001 | ||
| Incorrect | 52 | 36 | |
| Correct = 1–2 weeks | 7 | 23 | |
| Surgery will almost always alleviate pain. | 0.011 | ||
| Incorrect | 26 | 32 | |
| Correct = False | 14 | 46 | |
3.9. Paired t-test results from pre- and post-intervention
The paired t-test results revealed a notable shift in participants' opinions and expectations following an educational intervention related to meniscus injury management (Table 6). Importantly, a higher efficacy was perceived across non-surgical interventions for both acute and degenerative meniscus tears. Also, post-intervention ratings for surgery decreased significantly concerning its effectiveness for degenerative tears (t = 5.5, p < 0.001).
Table 6.
Paired t-test of Pre- and Post-intervention Opinion Items (n = 118).
| Mean | SD | t | p-value | |
|---|---|---|---|---|
| Number correct responses: | −12.4 | <0.001 | ||
| Pre-intervention | 3.2 | 1.9 | ||
| Post-intervention | 5.3 | 1.7 | ||
| What do you expect the pain from a meniscus surgery to be? | 3.2 | 0.002 | ||
| Pre-intervention | 6.3 | 1.7 | ||
| Post-intervention | 5.7 | 2.2 | ||
| Effectiveness of treatments for Acute Injuries: | ||||
| Physical Therapy: | 1.1 | 0.277 | ||
| Pre-intervention | 6.5 | 2.2 | ||
| Post-intervention | 6.2 | 2.8 | ||
| Rest and Ice: | −2.4 | 0.017 | ||
| Pre-intervention | 5.6 | 2.5 | ||
| Post-intervention | 6.2 | 2.7 | ||
| Anti-inflammatory Medications: | −2.0 | 0.047 | ||
| Pre-intervention | 5.9 | 2.2 | ||
| Post-intervention | 6.4 | 2.5 | ||
| Steroid Injections: | −2.6 | 0.009 | ||
| Pre-intervention | 5.7 | 2.3 | ||
| Post-intervention | 6.3 | 2.5 | ||
| Surgery: | 0.7 | 0.502 | ||
| Pre-intervention | 8.2 | 1.7 | ||
| Post-intervention | 8.0 | 2.2 | ||
| Biological Injections: | −2.5 | 0.015 | ||
| Pre-intervention | 5.7 | 2.3 | ||
| Post-intervention | 6.3 | 2.5 | ||
| Effectiveness of treatments for Degenerative Tears: | ||||
| Physical Therapy: | −7.0 | <0.001 | ||
| Pre-intervention | 6.1 | 2.6 | ||
| Post-intervention | 7.7 | 2.1 | ||
| Rest and Ice: | −9.1 | <0.001 | ||
| Pre-intervention | 5.0 | 2.5 | ||
| Post-intervention | 7.2 | 2.5 | ||
| Anti-inflammatory Medications: | −8.4 | <0.001 | ||
| Pre-intervention | 5.7 | 2.3 | ||
| Post-intervention | 7.3 | 2.1 | ||
| Steroid Injections: | −7.5 | <0.001 | ||
| Pre-intervention | 5.8 | 2.2 | ||
| Post-intervention | 7.4 | 2.2 | ||
| Surgery: | 5.5 | <0.001 | ||
| Pre-intervention | 7.2 | 2.4 | ||
| Post-intervention | 5.5 | 3.0 | ||
| Biological Injections: | −6.0 | <0.001 | ||
| Pre-intervention | 5.9 | 2.5 | ||
| Post-intervention | 7.3 | 2.1 | ||
4. Discussion
The general population exhibited a notable deficiency in fundamental understanding concerning meniscus tears. The majority of respondents did not understand basic anatomy regarding meniscus function or pathology, or epidemiology. 65% of respondents did not understand the correlation with future progression of osteoarthritis. Surprisingly, 76% believed that surgery was required for most meniscus tears, and 84% thought most meniscus tears could be repaired (as opposed to debridement). Finally, most perceived surgery to be painful (mean VAS 7/10) and believed it would take more than 3 months to return to running and sports. Optimistically, the brief educational intervention significantly improved baseline knowledge and altered several misconceptions.
Overall, the public’s understanding of degenerative tears and their treatment was limited. 76% of participants viewed surgery as necessary to appropriately treat degenerative meniscus tears and perceived low efficacy of non-surgical treatments. Multiple studies have demonstrated a lack of efficacy for routine surgical intervention for degenerative medial meniscus tears regarding knee pain, function, or quality of life.17,18 When asked about the potential for meniscus tears to “heal naturally,” 67.3% were skeptical. It is known that peripheral tears located in the outer 1/3rd of the meniscus have better healing potential due to a peripheral-based blood supply.16 Other expectations included significant pain (VAS 7/10) and a prolonged recovery (standing and walking >2 weeks and return to running and sports >3 months). The educational intervention effectively corrected misconceptions about non-surgical treatment and the perceived need for surgery for degenerative meniscus tears. Our study revealed a high perceived risk of complications relating to meniscal surgery. The average risk rating for post-surgery infection and blood clots was assessed at 42%. However, following surgery, complications such as blood clots, nerve damage, and infection are uncommon, occurring in less than 1% of all patients.19, 20, 21
Although grasping the intricate anatomy of the meniscus may not be perceived as immediately critical for patient care, it underscores a lack of common knowledge in the general public. Meniscus tears stem from either acute injuries or degenerative tears (chronic wear and tear), which were identified by 63% of respondents.22 For acute injuries, participants ranked treatments from most to least effective as: surgery, physical therapy, anti-inflammatory medications, biological injections, rest and ice, and steroid injections. Indications for meniscus repair hinge on patient factors such as age (under 40), activity level, significant comorbidities, and compliance with post-surgical rehabilitation. Tear characteristics, including tear pattern, zone of injury, and association with ACL reconstruction, also play pivotal roles in determining appropriate treatment approaches.23 Noteworthy, only 34.7% of participants associated meniscus tears with potential osteoarthritis development. Meniscal tears are well-known to lead to the advancement of knee osteoarthritis. The meniscus plays a vital role in facilitating weight distribution, absorbing stress, and maintaining knee joint stability.12 Remarkably, a previous study revealed that incidental meniscal tears were associated with a 10-fold higher risk of developing osteoarthritis within a 30-month period.24
Significant knowledge gaps may lead to improper expectations. Particularly striking in this study were misconceptions surrounding the expected timeline for returning to standing/walking and running/sports following partial meniscectomy, with 23% even anticipating a timeline exceeding one-year post-surgery. Based on the literature, a return to normal activities normally occurs within 6–8 weeks.14 These misunderstandings can potentially delay treatment, leading to poorer outcomes such as increased meniscal degeneration or disease progression.25 The intervention leads to an improvement in expectations regarding the treatment timeline. A previous study demonstrated that patients who received pre-operative education regarding their current condition demonstrated higher satisfaction levels, particularly regarding topics such as postoperative complications, pain management, and recovery time.26 Enhancing patients' understanding of their diagnosis and medical plan cultivates a more collaborative dynamic between patients and physicians, ultimately leading to improved patient outcomes.27
A bivariate comparison revealed several significant associations between patient characteristics and correct or incorrect responses to the seven scoreable items. Males and participants with a medical background or prior experience with a meniscus tear diagnosis showed higher accuracy rates. In particular, younger participants (aged 18–29) demonstrated higher rates of incorrect choices compared to the older age groups (p < 0.001). While this study confirms the presence of widespread misconceptions among the public regarding this information, it also illustrates that a short educational intervention can substantially expand the public’s understanding regardless of patient age, demographic, educational status, or prior experience with meniscus injuries. Arming the public with basic information on this common injury pattern and its treatment options is paramount to setting patient expectations on how their injury is managed (whether non-surgically or surgically) and how soon they can expect to return to daily activities and sports. With this information, we hope to build trust and strength in the patient-physician relationship. One way to improve awareness and reduce misconceptions about meniscus tears and other orthopedic conditions is to create concise, easy-to-read brochures featuring images that clearly explain the condition, along with basic information on diagnosis, treatment options, and expected recovery time. Additionally, including a QR code for patients to scan and access brief videos or presentations can be helpful for those who prefer visual learning over reading.
4.1. Limitations
This study had several important limitations. One significant challenge stem from the nature of meniscus injuries, which encompass a breadth of clinical presentations and tear types, underlying factors, and prognoses, which lend to a tailored treatment approach. While striving to simplify the complexity surrounding meniscus tears, it also carries the risk of oversimplification. Furthermore, our study is limited by the demographic profile of our participants, as they were sourced from various online and social media platforms, naturally creating sampling bias. Additionally, we did not distinguish between survey responses collected from these different platforms. To address sampling bias, a broader approach that includes non-digital media should be considered, such as using recruitment posters displayed in public areas. Future research could evaluate patients at the time of treatment to directly address misconceptions with the treating physician. The length of the survey and the number of questions could have contributed to a lower response rate due to fatigue and increased likelihood of rushed or inaccurate responses. This data can guide the design of a larger, more comprehensive study on perceptions and misconceptions related to meniscus tears or other orthopaedic injuries. Future steps could involve conducting research in a clinical setting using surveys to gather patients' perceptions before their consultation with the surgeon. The surgeon could then address the misconceptions identified in the survey, then administer the same survey afterward to evaluate improvements in knowledge and accuracy of responses.
5. Conclusion
This study identified significant misconceptions in the general public about meniscus tears and shows that a targeted educational intervention can significantly improve knowledge. Participants demonstrated notable gains in understanding meniscus anatomy, its link to osteoarthritis, and accurate perceptions of non-operative and surgical treatment options. These findings highlight the importance of education in aligning expectations with current medical practices to enhance the patient-provider relationship and thus improve the overall quality of care.
Informed consent statement
Informed consent was obtained from all subjects involved in the study.
Ethical approval statement
The study was conducted in compliance with the principles outlined in the Declaration of Helsinki and approved by the Institutional Review Board (or Ethics Committee) of Vanderbilt University Medical Center (IRB #231240 on August 22, 2023).
Credit author statement
Beshoy A. William: Conceptualization, Methodology, Software, Investigation, Resources, Data Curation, Writing - Original Draft, Visualization. Eric N. Bowman, MD, MPH: Validation, Writing - Review & Editing, Supervision, Project Administration. Claudia Davidson, MPH: Formal Analysis, Data Curation.
What is known about the subject
There is a significantly limited amount of published information regarding the public’s understanding of meniscus tears and their management. However, there are several notable misunderstandings among the general public that physicians should be aware of when counseling patients concerning meniscus tears.
What this study adds to existing knowledge
Evaluating the public’s knowledge level concerning meniscus tears is essential for developing effective educational and preventive approaches that will ultimately improve patient expectations and outcomes.
Source of funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Declaration of competing interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Acknowledgments
We would like to acknowledge Rick Wright and the Vanderbilt Department of Orthopedics for their generous support, as well as V. V. N. Manohar Devarasetty for his invaluable assistance and efforts.
Footnotes
This study was performed at Vanderbilt University Medical Center – Orthopaedic Department, 1215 21st Avenue South, Nashville, Tennessee 37232.
Contributor Information
Beshoy A. William, Email: Bwilliam23@mmc.edu.
Claudia Davidson, Email: Claudia.davidson@vumc.org.
Eric N. Bowman, Email: Eric.N.Bowman@vumc.org.
References
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