Does MRI add value in general practice for patients with traumatic knee complaints? A 1-year randomised controlled trial.
Br J Sports Med
; 53(20): 1285-1292, 2019 Oct.
Article
em En
| MEDLINE
| ID: mdl-30042140
ABSTRACT
OBJECTIVE:
To determine whether referral to MRI by the general practitioner (GP) is non-inferior to usual care (no access to MRI by GPs) in patients with traumatic knee complaints regarding knee-related daily function.METHODS:
This was a multicentre, non-inferiority randomised controlled trial with 1-year follow-up. GPs invited eligible patients during or after their consultation. Eligible patients (18-45 years) consulted a GP with knee complaints due to a trauma during the previous 6 months. Patients allocated to the MRI group received an MRI at (median) 7 (IQR 1-33) days after the baseline questionnaire. Patients in the usual care group received information on the course of knee complaints, and a referral to a physiotherapist or orthopaedic surgeon when indicated. The primary outcome measure was knee-related daily function measured with the Lysholm scale (0 to 100; 100=excellent function) over 1 year, with a non-inferiority margin of 6 points.RESULTS:
A total of 356 patients were included and randomised to MRI (n=179) or usual care (n=177) from November 2012 to December 2015. MRI was non-inferior to usual care concerning knee-related daily function during 1-year follow-up, for the intention-to-treat (overall adjusted estimate 0.33; 95% CI -1.73 to 2.39) and per-protocol (overall adjusted estimate 0.06; 95% CI -2.08 to 2.19) analysis. There were no differences between both groups in the amount of patients visiting other healthcare providers.CONCLUSION:
MRI in general practice in patients with traumatic knee complaints was non-inferior to usual care regarding knee-related daily function during 1-year follow-up. TRIAL REGISTRATION NUMBER NTR3689.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Imageamento por Ressonância Magnética
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Medicina Geral
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Traumatismos do Joelho
Tipo de estudo:
Clinical_trials
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Guideline
Limite:
Adult
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Female
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Humans
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Male
País/Região como assunto:
Europa
Idioma:
En
Revista:
Br J Sports Med
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Holanda