Abstract
Background Although guidelines advocate conservative treatment, it is unclear how GPs manage patients with a suspected meniscal tear.
Aim To provide a clear understanding of the frequency of patients that are conservatively treated or are referred to secondary care, and whether this management is associated with age, trauma and locking complaints, and varied between general practices.
Method Data was extracted from a GP database of routinely collected data. Subjects of 18–75 years old who attended their GP from 2005 up to and including 2015 in the area of Amsterdam with suspected meniscal tear were included. Groups were defined as 1) conservative treatment, 2) referral to secondary care after conservative treatment and 3) instant referral.
Results We retrieved 394 records. One hundred and twenty-two (31%) subjects were treated conservatively, 107 (27%) were referred after conservative treatment and 165 (42%) subjects were instantly referred to secondary care. This implies that of all subjects with a suspected meniscal tear, 69% were referred to secondary care of which more than 60% instantaneously. Subjects >40 years of age were more often referred than subjects ≤40 years (P = 0.013). Significant variation between GP practices occurred as initial referral and referral after conservative treatment ranged between 56% to 84% (P = 0.011).
Conclusion In Dutch GP practices, the majority of patients with suspicion meniscal tear are referred to secondary care. Older subjects are more frequently referred than younger subjects. The management of such patients varies substantially between GP practices. Findings emphasize the need for individualized risk predictions to guide decisions regarding the management of suspected meniscal tears.
- © British Journal of General Practice 2018