title: Predictors of persistent complaints after a knee injury in primary care.
abstract: BACKGROUND
  Prognosis of persistent complaints after knee injury is based on secondary care populations. In a primary care setting, however, no studies have addressed this issue.
  
  
  OBJECTIVE
  To identify possible predictors of persistent complaints 1 year after a knee injury. These predictors are important for guiding the GP's therapeutic management, and giving advice to patients about work and/or sports-related activities.
  
  
  METHODS
  Primary care prospective cohort study with a 1-year follow-up period in five municipalities in the southwest region of the Netherlands.
  
  
  METHODS
  Patients who were eligible were recruited to the study by a GP research network with around 84,000 patients and 40 participating GPs. A total of 134 patients (aged 18-65 years) who consulted their GP within 5 weeks after a knee injury entered the study. Follow-up after 1 year was conducted in 122 patients. The main outcome was persistent complaints 1 year after injury; possible predictors for these complaints were obtained with a questionnaire, a physical examination, and magnetic resonance imaging (MRI), according to a standardised protocol.
  
  
  RESULTS
  After 1 year, of the 122 available patients, 21 (17%) reported persistent complaints and 101 (83%) reported full recovery or major improvement. In this study being aged >40 years had a significant association (P<0.05) with persistent complaints (odds ratio 8.0, 95% confidence interval 2.1 to 30.5). Physical examination and MRI findings revealed no predictors that were associated with these complaints.
  
  
  CONCLUSIONS
  Being aged >40 years was the only determinant with a significant association with persistent complaints. As physical examination and MRI had no predictive value, they are not recommended for prognosis of persistent complaints.
authors.affiliation: Department of General Practice, Erasmus Medical Center, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Harry P A
authors.initials: HP
authors.lastname: Wagemakers
authors.forename: Pim A J
authors.initials: PA
authors.lastname: Luijsterburg
authors.forename: Edith M
authors.initials: EM
authors.lastname: Heintjes
authors.forename: Marjolein Y
authors.initials: MY
authors.lastname: Berger
authors.forename: Jan A N
authors.initials: JA
authors.lastname: Verhaar
authors.forename: Bart W
authors.initials: BW
authors.lastname: Koes
authors.forename: Sita M A
authors.initials: SM
authors.lastname: Bierma-Zeinstra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000070598:Anterior Cruciate Ligament Injuries; D002908:Chronic Disease; D005194:Family Practice; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D008487:Medical History Taking / Q000379:methods; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands; D010808:Physical Examination / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D020127:Recovery of Function; D012421:Rupture / Q000175:diagnosis; D000070600:Tibial Meniscus Injuries; D055815:Young Adult