{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T20:54:32Z","timestamp":1773608072614,"version":"3.50.1"},"reference-count":60,"publisher":"BMJ","issue":"1","funder":[{"name":"Danish Council for Independent Research | Medical Sciences","award":["#6110-00092B"],"award-info":[{"award-number":["#6110-00092B"]}]},{"name":"Danish Council for Independent Research | Medical Sciences","award":["(#12-125457"],"award-info":[{"award-number":["(#12-125457"]}]},{"DOI":"10.13039\/501100024075","name":"Region of Southern Denmark","doi-asserted-by":"crossref","award":["(#15\/50982"],"award-info":[{"award-number":["(#15\/50982"]}],"id":[{"id":"10.13039\/501100024075","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2019,5,13]]},"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Despite absence of evidence of a clinical benefit of arthroscopic partial meniscectomy (APM), many surgeons claim that subgroups of patients benefit from APM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We developed a prognostic model predicting change in patient-reported outcome 1\u2009year following arthroscopic meniscal surgery to identify such subgroups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included 641 patients (age 48.7 years (SD 13), 56% men) undergoing arthroscopic meniscal surgery from the Knee Arthroscopy Cohort Southern Denmark. 18 preoperative factors identified from literature and\/or orthopaedic surgeons (patient demographics, medical history, symptom onset and duration, knee-related symptoms, etc) were combined in a multivariable linear regression model. The outcome was change in Knee injury and Osteoarthritis Outcome Score (KOOS<jats:sub>4<\/jats:sub>) (average score of 4 of 5 KOOS subscales excluding the activities of daily living subscale) from presurgery to 52 weeks after surgery. A positive KOOS<jats:sub>4<\/jats:sub>change score constitutes improvement. Prognostic performance was assessed using R<jats:sup>2<\/jats:sup>statistics and calibration plots and was internally validated by adjusting for optimism using 1000 bootstrap samples.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients improved on average 18.6 (SD 19.7, range \u221238.0 to 87.8) in KOOS<jats:sub>4<\/jats:sub>. The strongest prognostic factors for improvement were (1) no previous meniscal surgery on index knee and (2) more severe preoperative knee-related symptoms. The model\u2019s overall predictive performance was low (apparent R<jats:sup>2<\/jats:sup>=0.162, optimism adjusted R<jats:sup>2<\/jats:sup>=0.080) and it showed poor calibration (calibration-in-the-large=0.205, calibration slope=0.772).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite combining a large number of preoperative factors presumed clinically relevant, change in patient-reported outcome 1\u2009year following meniscal surgery was not predictable. This essentially quashes the existence of \u2018subgroups\u2019 with certain characteristics having a particularly favourable outcome after meniscal surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" specific-use=\"clinicaltrial results\" xlink:href=\"NCT01871272\">NCT01871272<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bjsports-2018-100321","type":"journal-article","created":{"date-parts":[[2019,6,11]],"date-time":"2019-06-11T21:15:26Z","timestamp":1560287726000},"page":"13-22","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Wild goose chase \u2013 no predictable patient subgroups benefit from meniscal surgery: patient-reported outcomes of 641 patients 1 year after surgery"],"prefix":"10.1136","volume":"54","clinical-trial-number":[{"clinical-trial-number":"nct01871272","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct01871272","registry":"10.18810\/clinical-trials-gov","type":"results"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6910-5255","authenticated-orcid":false,"given":"Kenneth","family":"Pihl","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joie","family":"Ensor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Peat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Englund","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5424-9448","authenticated-orcid":false,"given":"Stefan","family":"Lohmander","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uffe","family":"J\u00f8rgensen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nis","family":"Nissen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jakob Vium","family":"Fristed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7789-8224","authenticated-orcid":false,"given":"Jonas Bloch","family":"Thorlund","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,6,11]]},"reference":[{"key":"2024100707300775000_54.1.13.1","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.1001\/jama.2018.13308","article-title":"Effect of early surgery vs physical therapy on knee function among patients with nonobstructive meniscal tears: the escape randomized clinical trial","volume":"320","author":"van de Graaf","year":"2018","journal-title":"JAMA"},{"key":"2024100707300775000_54.1.13.2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.140433"},{"key":"2024100707300775000_54.1.13.3","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.h2747","article-title":"Arthroscopic surgery for degenerative knee: systematic review and meta-analysis of benefits and harms","volume":"350","author":"Thorlund","year":"2015","journal-title":"BMJ"},{"key":"2024100707300775000_54.1.13.4","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-016114","article-title":"Knee arthroscopy versus conservative management in patients with degenerative knee disease: a systematic review","volume":"7","author":"Brignardello-Petersen","year":"2017","journal-title":"BMJ Open"},{"key":"2024100707300775000_54.1.13.5","doi-asserted-by":"crossref","unstructured":"Friberger Pajalic K , Turkiewicz A , Englund M . 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