Surgical decision making for arthroscopic partial meniscectomy in patients aged over 40 years. Academic Article uri icon

Overview

abstract

  • 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.

publication date

  • January 20, 2012

Research

keywords

  • Arthroscopy
  • Decision Support Techniques
  • Knee Injuries
  • Menisci, Tibial
  • Practice Patterns, Physicians'

Identity

Scopus Document Identifier

  • 84859215369

Digital Object Identifier (DOI)

  • 10.1016/j.arthro.2011.09.004

PubMed ID

  • 22264828

Additional Document Info

volume

  • 28

issue

  • 4