Effect of Preoperative Kinesiophobia on Clinical Outcomes Following Arthroscopic Meniscus Surgery (MEN-KIN)

Effect of Preoperative Kinesiophobia on Clinical Success in Patients Undergoing Arthroscopic Surgery for Meniscal Tears

Meniscal tears are among the most common knee injuries and frequently require arthroscopic surgical treatment when conservative management fails or mechanical symptoms persist. Although surgical techniques have improved clinical outcomes, postoperative recovery is influenced not only by structural pathology but also by psychological factors. Kinesiophobia, defined as an excessive and debilitating fear of movement due to pain or the expectation of reinjury, may negatively affect rehabilitation adherence, functional recovery, and pain perception.

This prospective observational study aims to investigate the effect of preoperative kinesiophobia on postoperative clinical outcomes in patients undergoing arthroscopic surgery for meniscal tears. Adult patients diagnosed with a meniscal tear by clinical examination and magnetic resonance imaging and scheduled for arthroscopic surgery will be enrolled. Preoperative demographic and clinical characteristics, pain intensity, functional status, and kinesiophobia levels will be assessed using validated outcome measures. Postoperative evaluations will be performed three months after surgery to determine changes in pain and functional outcomes. The relationship between preoperative kinesiophobia and postoperative clinical success will be analyzed. The findings of this study may help identify patients at risk for suboptimal recovery and support the development of individualized rehabilitation strategies.

Study Overview

• Status: Not yet recruiting
• Conditions: Meniscal Tear

Detailed Description

Meniscal tears are among the most common knee injuries encountered in orthopedic practice and represent a major cause of knee pain, mechanical symptoms, and functional impairment. Although conservative treatment may be effective in selected patients, arthroscopic surgery remains a widely performed procedure for individuals with persistent symptoms or mechanical dysfunction. Despite advances in surgical techniques and standardized rehabilitation protocols, postoperative recovery varies considerably among patients with similar structural pathology, suggesting that factors beyond the anatomical lesion may influence clinical outcomes.

Psychological factors have increasingly been recognized as important determinants of recovery after musculoskeletal injuries and orthopedic surgery. Among these, kinesiophobia, defined as an excessive and debilitating fear of movement resulting from pain or the anticipation of reinjury, may negatively affect rehabilitation adherence, physical activity, muscle performance, and overall functional recovery. Patients with high levels of kinesiophobia may avoid movement, resulting in delayed restoration of knee function and persistent disability. However, evidence specifically evaluating the influence of preoperative kinesiophobia on outcomes following arthroscopic meniscal surgery remains limited.

The present study is designed as a prospective, single-center, observational cohort study to investigate the effect of preoperative kinesiophobia on postoperative clinical success in patients undergoing arthroscopic surgery for meniscal tears. Adult patients aged 18 to 65 years with a diagnosis of a meniscal tear confirmed by clinical examination and magnetic resonance imaging (MRI) and scheduled for arthroscopic surgery will be consecutively enrolled.

Baseline assessments will include demographic characteristics, body mass index, symptom duration, affected side, meniscal tear localization, and the type of arthroscopic procedure performed. Pain intensity will be evaluated using the Visual Analog Scale (VAS), functional status will be assessed using the Lysholm Knee Score, and fear of movement will be measured using the Tampa Scale for Kinesiophobia (TSK). All outcome measures will be recorded preoperatively and at the postoperative third month, providing a standardized assessment of changes in pain, function, and kinesiophobia over the early recovery period.

Participants will be categorized according to their preoperative kinesiophobia levels, and postoperative clinical outcomes will be compared between groups. In addition, correlation analyses will be performed to determine the relationship between preoperative kinesiophobia and postoperative pain and functional recovery. Appropriate statistical methods will be used to evaluate between-group differences and associations, with statistical significance defined as p < 0.05.

The findings of this study are expected to clarify the role of preoperative kinesiophobia as a potential predictor of postoperative clinical success following arthroscopic meniscal surgery. Improved understanding of this relationship may facilitate the identification of patients at risk for suboptimal recovery and support the development of individualized perioperative rehabilitation strategies that incorporate both physical and psychological components.

• Study Type: Observational
• Enrollment (Estimated): 50

Contacts and Locations

• Study Contact: Name: Erdal Güngör, M.D; Phone Number: +90 543 879 0630; Email: egungor_49@hotmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The study population will consist of adult patients aged 18-65 years who are diagnosed with a meniscal tear by clinical examination and magnetic resonance imaging (MRI) and are scheduled to undergo arthroscopic meniscal surgery at the Department of Orthopedics and Traumatology of a single tertiary care center. Eligible participants who provide written informed consent and meet the inclusion criteria will be enrolled consecutively. Preoperative and postoperative clinical assessments will be performed according to the study protocol.

Description

Inclusion Criteria:

Adults aged 18 to 65 years. Diagnosis of meniscal tear confirmed by clinical examination and magnetic resonance imaging (MRI).

Patients scheduled to undergo arthroscopic meniscal surgery. Ability to understand and complete the study questionnaires. Willingness to participate and provide written informed consent. Availability for both preoperative assessment and postoperative 3-month follow-up.

Exclusion Criteria:

Previous surgery on the affected knee. Concomitant anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), or collateral ligament injuries requiring surgical treatment.

Advanced knee osteoarthritis (e.g., Kellgren-Lawrence grade 3 or 4). History of inflammatory rheumatic disease or active joint infection. Neurological disorders affecting lower extremity function or balance. Severe psychiatric disorders or cognitive impairment preventing completion of questionnaires.

Pregnancy. Inability or unwillingness to provide written informed consent. Inability to attend the 3-month postoperative follow-up.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
High Kinesiophobia Group; Patients with meniscal tears scheduled for arthroscopic surgery who demonstrate high preoperative kinesiophobia based on the Tampa Scale for Kinesiophobia (TSK). Participants will undergo standard surgical treatment and routine postoperative rehabilitation and will be evaluated preoperatively and at the postoperative third month for pain and functional outcomes.
Low Kinesiophobia Group; Patients with meniscal tears scheduled for arthroscopic surgery who demonstrate low preoperative kinesiophobia based on the Tampa Scale for Kinesiophobia (TSK). Participants will undergo the same standard surgical treatment and routine postoperative rehabilitation and will be evaluated preoperatively and at the postoperative third month for pain and functional outcomes.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Lysholm Knee Score	To evaluate the change in knee function using the Lysholm Knee Score from baseline (preoperative assessment) to the postoperative 3-month follow-up in patients undergoing arthroscopic surgery for meniscal tears.	Baseline and postoperative 3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Visual Analog Scale (VAS) Pain Score	Assessment of postoperative pain intensity using the 10-cm Visual Analog Scale (VAS). Lower scores indicate less pain.	Baseline (preoperative) and postoperative 3 months.
Change in Tampa Scale for Kinesiophobia (TSK) Score	Assessment of fear of movement using the Tampa Scale for Kinesiophobia. Higher scores indicate greater kinesiophobia.	Baseline (preoperative) and postoperative 3 months.

Collaborators and Investigators

• Sponsor: Medipol University
• Investigators: Principal Investigator: Erdal Güngör, M.D, Istanbul Medipol University, Department of Orthopedics and Traumatology

Study record dates

Study Major Dates

• Study Start (Estimated): June 25, 2026
• Primary Completion (Estimated): December 15, 2026
• Study Completion (Estimated): December 30, 2026

Study Registration Dates

• First Submitted: June 12, 2026
• First Submitted That Met QC Criteria: June 12, 2026
• First Posted (Actual): June 17, 2026

Study Record Updates

• Last Update Posted (Actual): June 17, 2026
• Last Update Submitted That Met QC Criteria: June 12, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: MBH-ORTHO-2026-001

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No