{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T17:28:26Z","timestamp":1783704506659,"version":"3.55.0"},"reference-count":37,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T00:00:00Z","timestamp":1564617600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["837002009"],"award-info":[{"award-number":["837002009"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"name":"OLVG medical research foundation","award":["15u.025"],"award-info":[{"award-number":["15u.025"]}]},{"name":"Zilverenkruis Health Insurance","award":["Z436"],"award-info":[{"award-number":["Z436"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2019,7,7]]},"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To examine the ability of surgeons to predict the outcome of treatment for meniscal tears by arthroscopic partial meniscectomy (APM) and exercise therapy in middle-aged patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design and setting<\/jats:title>\n                  <jats:p>Electronic survey. Orthopaedic surgeon survey participants were presented 20 patient profiles. These profiles were derived from a randomised clinical trial comparing APM with exercise therapy in middle-aged patients with symptomatic non-obstructive meniscal tears. From each treatment group (APM and exercise therapy), we selected five patients with the best (responders) and five patients with the worst (non-responders) knee function after treatment. 1111 orthopaedic surgeons and residents in the Netherlands and Australia were invited to participate in the survey.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Interventions<\/jats:title>\n                  <jats:p>For each of the 20 patient profiles, surgeons (unaware of treatment allocation) had to choose between APM and exercise therapy as preferred treatment and subsequently had to estimate the expected change in knee function for both treatments on a 5-point Likert Scale. Finally, surgeons were asked which patient characteristics affected their treatment choice.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcomes<\/jats:title>\n                  <jats:p>The primary outcome was the surgeons\u2019 percentage correct predictions. We also compared this percentage between experienced knee surgeons and other orthopaedic surgeons, and between treatment responders and non-responders.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We received 194 (17%) complete responses for all 20 patient profiles, resulting in 3880 predictions. Overall, 50.0% (95% CI 39.6% to 60.4%) of the predictions were correct, which equals the proportion expected by chance. Experienced knee surgeons were not better in predicting outcome than other orthopaedic surgeons (50.4% vs 49.5%, respectively; p=0.29). The percentage correct predictions was lower for patient profiles of non-responders (34%; 95%\u2009CI 21.3% to 46.6%) compared with responders (66.0%; 95%\u2009CI 57.0% to 75.0%; p=0.01).<\/jats:p>\n                  <jats:p>In general, bucket handle tears, knee locking and failed non-operative treatment directed the surgeons\u2019 choice towards APM, while higher level of osteoarthritis, degenerative aetiology and the absence of locking complaints directed the surgeons\u2019 choice towards exercise therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Surgeons\u2019 criteria for deciding that surgery was indicated did not pass statistical examination. This was true regardless of a surgeon\u2019s experience. These results suggest that non-surgical management is appropriate as first-line therapy in middle-aged patients with symptomatic non-obstructive meniscal tears.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical trial registration<\/jats:title>\n                  <jats:p>ClinicalTrials.gov Identifier: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" specific-use=\"clinicaltrial results\" xlink:href=\"NCT03462134\">NCT03462134<\/jats:ext-link>.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bjsports-2019-100567","type":"journal-article","created":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T17:15:47Z","timestamp":1564679747000},"page":"354-359","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":30,"title":["Can even experienced orthopaedic surgeons predict who will benefit from surgery when patients present with degenerative meniscal tears? A survey of 194 orthopaedic surgeons who made 3880 predictions"],"prefix":"10.1136","volume":"54","clinical-trial-number":[{"clinical-trial-number":"nct03462134","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct03462134","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct03462134","registry":"10.18810\/clinical-trials-gov","type":"results"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5119-8887","authenticated-orcid":false,"given":"Victor A","family":"van de Graaf","sequence":"first","affiliation":[{"name":"Orthopaedic Surgery, Joint Research, OLVG, Amsterdam, The Netherlands"},{"name":"Orthopaedic Surgery, University Medical Centre, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"MD","given":"Coen H","family":"Bloembergen","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery, Joint Research, OLVG, Amsterdam, The Netherlands"},{"name":"Department of Orthopaedics, CORAL - Center for Orthopaedic Research Alkmaar, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"PhD","given":"Nienke W","family":"Willigenburg","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery, Joint Research, OLVG, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"MSc","given":"Julia C A","family":"Noorduyn","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery, Joint Research, OLVG, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel BF","family":"Saris","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery, University Medical Centre, Utrecht, The Netherlands"},{"name":"Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian A","family":"Harris","sequence":"additional","affiliation":[{"name":"Injury and Rehabilitation Research Department, Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia"},{"name":"Orthopaedic Department, South Western Sydney Local Health District, Liverpool Hospital, Liverpool, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudolf W","family":"Poolman","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery, Joint Research, OLVG, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,8,1]]},"reference":[{"key":"2025080112370559000_54.6.354.1","unstructured":"Steiner CA , Karaca Z , Moore BJ , et al . Surgeries in hospital-based ambulatory surgery and hospital inpatient settings. 2014: Statistical Brief # 2006;223."},{"key":"2025080112370559000_54.6.354.2","first-page":"1123","article-title":"Meniscus surgery is still widely performed in the treatment of degenerative meniscus tears in the Netherlands","volume":"26","author":"Rongen","year":"2018","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"2025080112370559000_54.6.354.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0800777"},{"key":"2025080112370559000_54.6.354.4","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-012-1960-3"},{"key":"2025080112370559000_54.6.354.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1301408"},{"key":"2025080112370559000_54.6.354.6","doi-asserted-by":"crossref","unstructured":"Kise NJ , Risberg MA , Stensrud S , et al . 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Temporal trends and regional variation in the rate of arthroscopic knee surgery in England: analysis of over 1.7 million procedures between 1997 and 2017. has practice changed in response to new evidence? Br J Sports Med 2018:bjsports-2018-099414.doi:10.1136\/bjsports-2018-099414","DOI":"10.1136\/bjsports-2018-099414"},{"key":"2025080112370559000_54.6.354.13","unstructured":"Frellick M . Skip Arthroscopy for Degenerative Knee Disease, Report Says. 2018 [updated 12\/5\/2018]. Available: https:\/\/www.medscape.com\/viewarticle\/879922"},{"key":"2025080112370559000_54.6.354.14","doi-asserted-by":"crossref","unstructured":"Jarvinen TLN , Guyatt GH . Arthroscopic surgery for knee pain. 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How do the costs of physical therapy and arthroscopic partial meniscectomy compare? A trial-based economic evaluation of two treatments in patients with meniscal tears alongside the escape study. Br J Sports Med 2019. doi:doi:10.1136\/bjsports-2018-100065. 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