Erasmus Medical Centre, Department of General Practice, Rotterdam, The Netherlands.
Br J Gen Pract. 2010 Feb;60(571):56-63. doi: 10.3399/bjgp10X483157.
BACKGROUND: Knee injuries may lead to pain and to functional limitations in the activities of daily living. Patients with knee injuries are frequently seen in general practice; however, the outcome and management in these patients is not known. AIM: To assess the outcome and management of knee injuries at 12 months' follow-up in general practice. DESIGN OF STUDY: A prospective observational cohort study with a 1-year follow-up. SETTING: Primary health care. METHOD: Adult patients consulting their GP after knee injury (n = 134) participated in the cohort. A magnetic resonance imaging scan was carried out and patients were diagnosed as either no lesion or an isolated meniscal tear, an isolated collateral or cruciate ligament lesion, or a combination. Follow-up questionnaires were filled in up to 12 months' follow-up. RESULTS: At 12 months' follow-up, 34 patients reported full recovery and 67 patients reported major improvement. At baseline, 37 patients (28%) were referred to physical therapy and 17 patients (13%) were referred to secondary care. During 1 year of follow-up, another 21 referrals to physical therapy and 11 referrals to secondary care took place. The pain severity decreased the most, and the Lysholm knee score increased in the majority of patients during the first 3 months after injury. In total, 18 arthroscopies were performed in 15 patients. One patient underwent an anterior cruciate ligament reconstruction. CONCLUSION: The vast majority of patients report clinically relevant recovery. There is no clear difference in outcomes between patients with meniscal tears or ligament lesions and patients without these diagnoses.
背景:膝关节损伤可导致疼痛,并使日常生活活动受限。在全科医疗中经常会遇到膝关节损伤的患者,但这些患者的结局和处理方法尚不清楚。
目的:评估全科医疗中膝关节损伤患者在 12 个月随访时的结局和处理方法。
研究设计:前瞻性观察队列研究,随访时间为 1 年。
研究地点:初级卫生保健。
方法:全科医疗就诊的膝关节损伤成年患者(n=134)参加了该队列研究。对患者进行磁共振成像扫描,根据检查结果将患者诊断为无病变、单纯半月板撕裂、单纯侧副韧带或十字韧带损伤或多种损伤。在 12 个月的随访期间,患者填写了随访问卷。
结果:在 12 个月的随访时,34 例患者报告完全康复,67 例患者报告有显著改善。在基线时,37 例患者(28%)被转诊到物理治疗,17 例患者(13%)被转诊到二级医疗。在 1 年的随访期间,又有 21 例转诊到物理治疗,11 例转诊到二级医疗。在损伤后的前 3 个月,大多数患者的疼痛严重程度下降最明显,Lysholm 膝关节评分增加。总共对 15 例患者中的 18 例行关节镜检查,1 例患者行前交叉韧带重建术。
结论:绝大多数患者报告有临床相关的恢复。半月板撕裂或韧带损伤患者与无这些诊断的患者的结局没有明显差异。
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