Botnar Research Centre, University of Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford, UK.
Bone Joint J. 2019 Jun;101-B(6):652-659. doi: 10.1302/0301-620X.101B6.BJJ-2019-0126.R1.
The aim of the British Association for Surgery of the Knee (BASK) Meniscal Consensus Project was to develop an evidence-based treatment guideline for patients with meniscal lesions of the knee.
A formal consensus process was undertaken applying nominal group, Delphi, and appropriateness methods. Consensus was first reached on the terminology relating to the definition, investigation, and classification of meniscal lesions. A series of simulated clinical scenarios was then created and the appropriateness of arthroscopic meniscal surgery or nonoperative treatment in each scenario was rated by the group. The process was informed throughout by the latest published, and previously unpublished, clinical and epidemiological evidence. Scenarios were then grouped together based upon the similarity of clinical features and ratings to form the guideline for treatment. Feedback on the draft guideline was sought from the entire membership of BASK before final revisions and approval by the consensus group.
A total of 45 simulated clinical scenarios were refined to five common clinical presentations and six corresponding treatment recommendations. The final guideline stratifies patients based upon a new, standardized classification of symptoms, signs, radiological findings, duration of symptoms, and previous treatment.
The 2018 BASK Arthroscopic Meniscal Surgery Treatment Guidance will facilitate the consistent identification and treatment of patients with meniscal lesions. It is hoped that this guidance will be adopted nationally by surgeons and help inform healthcare commissioning guidance. Validation in clinical practice is now required and several areas of uncertainty in relation to treatment should be a priority for future high-quality prospective studies. Cite this article: 2019;101-B:652-659.
英国膝关节外科学会（BASK）半月板共识项目的目的是制定基于证据的膝关节半月板病变患者治疗指南。
采用名义群体法、德尔菲法和适宜性方法进行正式的共识过程。首先就半月板病变的定义、检查和分类相关的术语达成共识。然后创建一系列模拟临床场景，并由专家组对每种场景下关节镜半月板手术或非手术治疗的适宜性进行评分。整个过程始终参考最新发表的和以前未发表的临床和流行病学证据。然后根据临床特征和评分的相似性将场景分组，形成治疗指南。在最终修订和共识小组批准之前，向 BASK 的全体成员征求对指南草案的反馈意见。
共细化了 45 个模拟临床场景，形成 5 种常见临床表现和 6 种相应的治疗建议。最终的指南根据新的、标准化的症状、体征、影像学发现、症状持续时间和既往治疗分类对患者进行分层。
2018 年 BASK 关节镜半月板手术治疗指南将有助于对半月板病变患者进行一致的识别和治疗。希望该指南能在全国范围内得到外科医生的采用，并有助于制定医疗保健委托指导。现在需要在临床实践中进行验证，并且应优先考虑与治疗相关的几个不确定领域，进行未来高质量的前瞻性研究。
2019;101-B:652-659.
