PURPOSE: To identify clinical variables that affect a surgeon's decision to recommend arthroscopic partial meniscectomy (APM). METHODS: Members of 2 orthopaedic specialty societies were invited to participate in an online survey by e-mail. The survey consisted of surgeon demographics and case scenarios to evaluate clinical decision making for APM. Posterior probabilities were calculated to determine the effect of clinical factors on the likelihood of recommending APM. RESULTS: Of the respondents with valid e-mail addresses, 733 (19.3%) returned a completed survey, but only 533 (14.1%) met the eligibility criteria (treated or referred an APM candidate within the past year). Respondents were aged 46.7 ± 9.4 and had performed a mean of 115 APMs in the previous year. Posterior probabilities for a combination of 6 clinical indicators identified 3 factors that most influenced a surgeon's decision to recommend APM: radiographic findings, McMurray test, and failure of nonoperative management. CONCLUSIONS: Significant variation exists among practicing orthopaedic surgeons with regard to decision making for APM. The 3 clinical factors that most influenced a surgeon's decision to recommend APM were normal radiographic findings, failed nonoperative treatment, and the presence of positive physical examination findings (i.e., positive McMurray test, joint line tenderness, and effusion). LEVEL OF EVIDENCE: Level III, decision analysis.
PURPOSE: To identify clinical variables that affect a surgeon's decision to recommend arthroscopic partial meniscectomy (APM). METHODS: Members of 2 orthopaedic specialty societies were invited to participate in an online survey by e-mail. The survey consisted of surgeon demographics and case scenarios to evaluate clinical decision making for APM. Posterior probabilities were calculated to determine the effect of clinical factors on the likelihood of recommending APM. RESULTS: Of the respondents with valid e-mail addresses, 733 (19.3%) returned a completed survey, but only 533 (14.1%) met the eligibility criteria (treated or referred an APM candidate within the past year). Respondents were aged 46.7 ± 9.4 and had performed a mean of 115 APMs in the previous year. Posterior probabilities for a combination of 6 clinical indicators identified 3 factors that most influenced a surgeon's decision to recommend APM: radiographic findings, McMurray test, and failure of nonoperative management. CONCLUSIONS: Significant variation exists among practicing orthopaedic surgeons with regard to decision making for APM. The 3 clinical factors that most influenced a surgeon's decision to recommend APM were normal radiographic findings, failed nonoperative treatment, and the presence of positive physical examination findings (i.e., positive McMurray test, joint line tenderness, and effusion). LEVEL OF EVIDENCE: Level III, decision analysis.
Authors: Jeffrey N Katz; Christine E Chaisson; Brian Cole; Ali Guermazi; David J Hunter; Morgan Jones; Bruce A Levy; Lisa A Mandl; Scott Martin; Robert G Marx; Clare Safran-Norton; Frank W Roemer; Debra Skoniecki; Daniel H Solomon; Kurt P Spindler; John Wright; Rick W Wright; Elena Losina Journal: Contemp Clin Trials Date: 2012-09-05 Impact factor: 2.226
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Authors: Raine Sihvonen; Mika Paavola; Antti Malmivaara; Ari Itälä; Antti Joukainen; Heikki Nurmi; Juha Kalske; Anna Ikonen; Timo Järvelä; Tero A H Järvinen; Kari Kanto; Janne Karhunen; Jani Knifsund; Heikki Kröger; Tommi Kääriäinen; Janne Lehtinen; Jukka Nyrhinen; Juha Paloneva; Outi Päiväniemi; Marko Raivio; Janne Sahlman; Roope Sarvilinna; Sikri Tukiainen; Ville-Valtteri Välimäki; Ville Äärimaa; Pirjo Toivonen; Teppo L N Järvinen Journal: Ann Rheum Dis Date: 2017-05-18 Impact factor: 19.103