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Metabolic Syndrome and Degenerate Meniscus Tears

Not Applicable
Completed
Conditions
Metabolic Syndrome
Meniscus; Degeneration
Interventions
Procedure: Early arthroscopic partial menisectomy group
Dietary Supplement: Calorie restricted diet and exercise intervention
Procedure: libitum diet and waiting list control group
Procedure: delayed APM group recruit participants with symptoms lasting for more than 6 months
Registration Number
NCT04837456
Lead Sponsor
The First People's Hospital of Jingzhou
Brief Summary

The aim is to determine the outcomes of calorie-restricted diet and exercise intervention; libitum diet and waiting list control; early arthroscopic partial meniscectomy(APM) or delayed APM effect on MetS patients with Degenerate menisucus lesions.

Detailed Description

The investigators recruited 180 patients with Metabolic Syndrome and knee symptoms with degenerate meniscus lesions by MRI from orthopaedics department from June 2017 to March 2020 at First Affiliated Hospital of Jinzhou Medical University. Participants were diagnosed with MetS and degenerate meniscus tear with a mild or no osteoarthritis KL\<2 verified by X ray. Participants were randomly dividied into calorie-restricted diet and exercise intervention group; libitum diet and waiting list control group; early APM (syndrome within 3-6 months) group or a delayed APM(syndrome more than 6 months) group as a computer sequenced number. The primary outcome was the change in metabolic syndrome components and knee function score of WOMAC, KOOS,WOMET,IKDC were determined by two fixed orthopadic surgeons who were blinded to the intervention.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
189
Inclusion Criteria
  • Must be age between 35 and 70 years old;
  • Clinical diagnosis of metabolic syndrome;
  • Clinical diagnosis of 3 grade degneration meniscus leisons;
Exclusion Criteria
  • Must be able to have no acute knee injury such as car crash or acute sports injury;
  • Must be able to have no knee surgeries history;
  • Must be able to have no rheumatoid arthritis or serious knee osteoarthritis with deformity;
  • Must be able to have no contraindications to MRI;
  • Must be able to have no severe cardiopulmonary disease;
  • Must be able to have no musculoskeletal or neuromuscular impairments ;
  • Must be able to have good visual, hearing, or cognitive;

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Early APM groupEarly arthroscopic partial menisectomy groupEarly APM group participants received APM with syndrome within 3 to 6 months
Calorie restricted diet and excecise interventionCalorie restricted diet and exercise interventiona balanced diet that provided an energy deficit of 800 kcal/day from their daily energy requirement \[36\]. Macronutrient content of low caloric diet, expressed as percentage of ingested energy with carbohydrates 45-65%; fat 20-35%; and protein 10- 35%\[36\].Each session was approximately 150 minutes one week for six months and consisted of aerobic exercises, resistance training, and exercises to improve flexibility and balance.
libitum diet and waiting list control grouplibitum diet and waiting list control groupparticipants then underwent a calorie of 2000 calorie above based on libitum free diets recommended to adults and normal physical activity without exercise during the program.
delayed APM group recruit participants with symptoms lasting for more than 6 monthsdelayed APM group recruit participants with symptoms lasting for more than 6 monthsdelayed APM group recruit participants with symptoms lasting for more than 6 months
Primary Outcome Measures
NameTimeMethod
Knee KOOS4up to 12 months

the Knee injury and Osteoarthritis Outcome Score (KOOS) holds five subscales: (1) Pain (9 items); (2) other Symptoms (7 items); (3) Activities of Daily Living (ADL, 17 items); (4) Sport and Recreation function (Sport/Rec, 5 items); and (5) knee-related Quality of Life (QoL, 4 items). Each subscale is scored separately from zero (extreme knee problems) to 100 (no knee problems) life (KOOs 4 ) were assessed.One of the most frequently-used knee-specific PROMs is the Knee injury and Osteoarthritis Outcome Score (KOOS) which was developed for adults who have knee OA or knee injuries.KOOS holds five subscales: (1) Pain (9 items); (2) other Symptoms (7 items); (3) Activities of Daily Living (ADL, 17 items); (4) Sport and Recreation function (Sport/Rec, 5 items); and (5) knee-related Quality of Life (QoL, 4 items). Each subscale is scored separately from zero (extreme knee problems) to 100 (no knee problems)

weightup to 12 months

weight in kilograms

heightup to 12 months

height in meters

triglycerideup to 12 months

triglyceride in mmol/L

LDL-Cup to 12 months

low-density lipoprotein cholesterol in mmol/L

β-2 microglobulinup to 12 months

β-2 microglobulin in mg/L

the scale of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)up to 12 months

the WOMAC score is a disease-specific self-report multidimensional questionnare assesing pain, siffness, and physical functional disability.WOMAC scores range from 0 to 100, with higher scores indicating worse physical function.

BMIup to 12 months

BMI, calculated as weight in kilograms divided by height in meters squaredBMI in kg/m\^2

cardio vascular disease historyup to 12 months

cardio vascular disease history

Kellgren-Lawrence gradeup to 12 months

A Kellgren-Lawrence grade of 0 indicates no osteoarthritis, a grade of 1 with questionable osteophyte indicates possible osteoarthritis; a grade of 2 with definite osteophyte and no joint-space narrowing indicates mild osteoarthritis, a grade of 3 with ≤50% joint-space narrowing or a grade of 4 with\>50% joint-space narrowing indicates severe osteoarthritis were excluded.

HDL-Cup to 12 months

high-density lipoprotein cholesterol in mmol/L

Lysholm knee scoreup to 12 months

The Lysholm knee score is based on an eight-item questionnaire designed to evaluate knee function and symptoms in activities of daily living. Scores range from 0 to 100; higher scores indicate less severe symptoms.

The International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC).up to 12 months

The IKDC is a questionnaire that has high reliability and validity for patients with a meniscal tear. The questionnaire contains 18 items scored in 1 of 3 ways: 11-point Likert scale, 5-point Likert scale, or dichotomous yes or no. After the participant completes the questionnaire, the scores are summed, and the total score is transformed to a value on a scale of 0 to 100, with 100 representing the highest knee function.

The WOMET scoreup to 12 months

The WOMET is a meniscus-specific health-related quality-of-life instrument, validated especially for patients with a degenerative meniscal tear.The Western Ontario Meniscal Evaluation Tool (WOMET) contains 16 items addressing three domains: 9 items ad-dressing physical symptoms; 4 items addressing disabilities with regard to sports, recreation, work, and lifestyle; and 3 items addressing emotions. The score indicates the percentage of a normal score; therefore, 100 is the best possi- ble score, and 0 is the worst possible score.

waist circumstanceup to 12 months

waist circumstance in centimeter

diastolic blood pressureup to 12 months

diastolic blood pressure in mm Hg

fast blood glucoseup to 12 months

fast blood glucose in mmol/L

total Cholesterolup to 12 months

total Cholesterol in mmol/L

diabetes historyup to 12 months

diabetes history

hypertension historyup to 12 months

hypertension history

systolic blood pressureup to 12 months

systolic blood pressure in mm Hg

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

First Affiliated Hospital of Jinzhou Medical University

🇨🇳

Jinzhou, Liaoning, China

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