Sökning: onr:"swepub:oai:lup.lub.lu.se:2717c572-750c-405b-a753-dea71a354ce9" >
Wild-goose chase, n...
Wild-goose chase, no predictable patient subgroups who benefit from meniscal surgery : patient-reported outcomes of 641 patients 1 year after surgery
-
- Pihl, Kenneth (författare)
- University of Southern Denmark
-
- Ensor, Joie (författare)
- Keele University
-
- Peat, George (författare)
- Keele University
-
visa fler...
-
- Englund, Martin (författare)
- Lund University,Lunds universitet,Lund OsteoArthritis Division - Clinical Epidemiology Unit,Forskargrupper vid Lunds universitet,Lund University Research Groups,Boston University
-
- Lohmander, Stefan (författare)
- Lund University,Lunds universitet,Lund OsteoArthritis Division - Nedbrytning av ledbrosk: en biologisk process som leder till artros,Forskargrupper vid Lunds universitet,Lund OsteoArthritis Division - Molecular marker research group,Lund University Research Groups
-
- Jørgensen, Uffe (författare)
- Odense University Hospital
-
- Nissen, Nis (författare)
- Lillebaelt Hospital
-
- Fristed, Jakob Vium (författare)
- Lillebaelt Hospital
-
- Thorlund, Jonas Bloch (författare)
- University of Southern Denmark
-
visa färre...
-
(creator_code:org_t)
- 2019-06-11
- 2020
- Engelska.
-
Ingår i: British journal of sports medicine. - : BMJ. - 1473-0480 .- 0306-3674. ; 54:1, s. 13-22
- Relaterad länk:
-
http://dx.doi.org/10...
-
visa fler...
-
https://eprints.keel...
-
https://lup.lub.lu.s...
-
https://doi.org/10.1...
-
visa färre...
Abstract
Ämnesord
Stäng
- BACKGROUND: Despite absence of evidence of a clinical benefit of arthroscopic partial meniscectomy (APM), many surgeons claim that subgroups of patients benefit from APM.OBJECTIVE: We developed a prognostic model predicting change in patient-reported outcome 1 year following arthroscopic meniscal surgery to identify such subgroups.METHODS: We included 641 patients (age 48.7 years (SD 13), 56% men) undergoing arthroscopic meniscal surgery from the Knee Arthroscopy Cohort Southern Denmark. 18 preoperative factors identified from literature and/or orthopaedic surgeons (patient demographics, medical history, symptom onset and duration, knee-related symptoms, etc) were combined in a multivariable linear regression model. The outcome was change in Knee injury and Osteoarthritis Outcome Score (KOOS4) (average score of 4 of 5 KOOS subscales excluding the activities of daily living subscale) from presurgery to 52 weeks after surgery. A positive KOOS4 change score constitutes improvement. Prognostic performance was assessed using R2 statistics and calibration plots and was internally validated by adjusting for optimism using 1000 bootstrap samples.RESULTS: Patients improved on average 18.6 (SD 19.7, range -38.0 to 87.8) in KOOS4. The strongest prognostic factors for improvement were (1) no previous meniscal surgery on index knee and (2) more severe preoperative knee-related symptoms. The model's overall predictive performance was low (apparent R2=0.162, optimism adjusted R2=0.080) and it showed poor calibration (calibration-in-the-large=0.205, calibration slope=0.772).CONCLUSION: Despite combining a large number of preoperative factors presumed clinically relevant, change in patient-reported outcome 1 year following meniscal surgery was not predictable. This essentially quashes the existence of 'subgroups' with certain characteristics having a particularly favourable outcome after meniscal surgery.TRIAL REGISTRATION NUMBER: NCT01871272.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Ortopedi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Orthopaedics (hsv//eng)
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
Hitta via bibliotek
Till lärosätets databas