Predicting no return to sports after three months in patients with traumatic knee complaints in general practice by combining patient characteristics, trauma characteristics and knee complaints

Abstract

Background: It remains unclear to what extent patients with traumatic knee complaints aged 18–45 years seen in general practice experience difficulties with return to sports.

Objectives: This study aims to determine the proportion of patients with a knee trauma that return to sports at six weeks and three months follow-up. Also examined were associations between no return to sports and baseline patient/trauma characteristics, knee complaints and MR (magnetic resonance) findings, as well as the additive value of MR findings.

Methods: Included were patients with traumatic knee complaints participating in a randomized controlled trial assessing the cost-effectiveness of an MR scan in general practice. Patients were classified as ‘no return to sports’ or ‘return to sports’ (sports on pre-injury or adapted level). Potential baseline predictors for no return to sports were assessed using logistic regression analyses. The area under the curves (AUC) was compared.

Results: At six weeks and three months follow-up, 147 (59%) and 175 (74%) patients, respectively, reported return to sports. Combining patient characteristics, trauma characteristics and knee complaints predicted no return to sports with an AUC of 0.86 (95%CI: 0.81–0.90) at six weeks and of 0.82 (95%CI: 0.76–0.88) at three months follow-up. After adding MR findings, the AUC was 0.79 (95%CI: 0.71–0.87) at six weeks and 0.79 (95%CI: 0.70–0.88) at three months follow-up.

Conclusion: Three out of four patients with a knee trauma in general practice reported return to sports at three months follow-up. A combination of patient/trauma characteristics and knee complaints predicted no return to sports, whereas MR findings had no additive value.

 

Trial registration: Dutch trial registration: registration number: NTR3689. registration date: 7 November 2012.

Keywords:

• Knee injuries
• primary care
• general practice
• magnetic resonance imaging
• return to sport

Acknowledgements

The authors thank all the participating patients and GPs. The authors also thank the radiologists involved in this study: JFH Veldhuizen (MRI Centrum, several locations), PWJ Vincken (Alrijne Hospital, Leiderdorp), MJA Smid-Geirnaerdt (Admiraal de Ruyter Hospital, Goes), HJ van der Woude (Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam), CF van Dijke (Northwest Clinics, Alkmaar) and AC van Breda Vriesman (Alrijne Hospital, Leiderdorp). Furthermore, the authors thank Jan Alberts for his help in the design and management of the secured online environment in which encrypted questionnaires were filled in by patients. Radiologists completed MR reports in which the data was stored. The authors thank Diana van Emmerik for her help in the data collection.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

The TACKLE trial is financially supported by the Netherlands Organisation for Health Research and Development (ZonMW). This study is partly funded by a programme grant of the Dutch Arthritis Foundation. The funders have no involvement in the study design; in the collection, analysis and interpretation of the data and in writing the manuscript.