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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
189
the calorie restricted diet were prescribed a balanced diet that provided an energy deficit of 800 kcal/day from their daily energy requirement.Macronutrient content of low caloric diet, expressed as percentage of ingested energy with carbohydrates 45-65%; fat 20-35%; and protein 10- 35%\[36\]. Participants were guided by a dietitian for adjustments of their caloric intake weekly for six months.Participants performed 1 or 2 sets at a resistance of approximately 65% of their one-repetition maximum, with 8 to 12 repetitions of each exercise; they gradually increased the intensity to 2 to 3 sets at a resistance of approximately 80% of their one-repetition maximum, with 6 to 8 repetitions of each exercise.
libitum diet and waiting list control group, participants 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.
First Affiliated Hospital of Jinzhou Medical University
Jinzhou, Liaoning, China
Knee KOOS4
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)
Time frame: up to 12 months
the scale of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)
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.
Time frame: up to 12 months
The International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC).
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.
Time frame: up to 12 months
The WOMET score
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.
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Early APM group participants received APM with syndrome within 3 to 6 months
delayed APM group recruit participants with symptoms lasting for more than 6 months
Time frame: up to 12 months
height
height in meters
Time frame: up to 12 months
weight
weight in kilograms
Time frame: up to 12 months
BMI
BMI, calculated as weight in kilograms divided by height in meters squaredBMI in kg/m\^2
Time frame: up to 12 months
waist circumstance
waist circumstance in centimeter
Time frame: up to 12 months
Kellgren-Lawrence grade
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.
Time frame: up to 12 months
systolic blood pressure
systolic blood pressure in mm Hg
Time frame: up to 12 months
diastolic blood pressure
diastolic blood pressure in mm Hg
Time frame: up to 12 months
triglyceride
triglyceride in mmol/L
Time frame: up to 12 months
HDL-C
high-density lipoprotein cholesterol in mmol/L
Time frame: up to 12 months
LDL-C
low-density lipoprotein cholesterol in mmol/L
Time frame: up to 12 months
fast blood glucose
fast blood glucose in mmol/L
Time frame: up to 12 months
total Cholesterol
total Cholesterol in mmol/L
Time frame: up to 12 months
β-2 microglobulin
β-2 microglobulin in mg/L
Time frame: up to 12 months
diabetes history
diabetes history
Time frame: up to 12 months
cardio vascular disease history
cardio vascular disease history
Time frame: up to 12 months
hypertension history
hypertension history
Time frame: up to 12 months
Lysholm knee score
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.
Time frame: up to 12 months