PT  - JOURNAL ARTICLE
AU  - M Kastelein
AU  - P A J Luijsterburg
AU  - E M Heintjes
AU  - M van Middelkoop
AU  - J A N Verhaar
AU  - B W Koes
AU  - S M A Bierma-Zeinstra
TI  - The 6-year trajectory of non-traumatic knee symptoms (including patellofemoral pain) in adolescents and young adults in general practice: a study of clinical predictors
AID  - 10.1136/bjsports-2014-093557
DP  - 2015 Mar 01
TA  - British Journal of Sports Medicine
PG  - 400--405
VI  - 49
IP  - 6
4099  - http://bjsm.bmj.com/content/49/6/400.short
4100  - http://bjsm.bmj.com/content/49/6/400.full
SO  - Br J Sports Med2015 Mar 01; 49
AB  - Aims (1) To assess the 1-year and 6-year courses of non-traumatic knee symptoms in adolescents and young adults presenting in general practice. (2) To identify prognostic factors for persistent knee symptoms at 1-year follow-up. Methods Adolescents and young adults (12–35 years; n=172) with non-traumatic knee symptoms were included in the cohort study by their general practitioner (GP) and followed for 6 years. Multivariable logistic regression analysis was used to identify prognostic factors for persistent knee symptoms at 1-year follow-up and the area under the receiver operating curve (AUC) was calculated. Results Persistent knee symptoms in patients receiving a GP diagnosis of unspecified knee symptoms were reported by 41% of the patients at 1-year follow-up and by 19% of the available patients at 6-year follow-up. Patients receiving a GP diagnosis of patellofemoral pain syndrome had the worse prognosis, with 40% reporting persistent knee symptoms at 6-year follow-up. Prognostic factors associated with persistent knee symptoms at 1-year follow-up were BMI >25, low/middle education level, bilateral symptoms and self-reported absence of crepitus of the knee (AUC 0.80) for patients receiving a GP diagnosis of unspecified knee symptoms. For patients receiving a GP diagnosis of patellofemoral pain syndrome, prognostic factors were low/middle education level, poor health, having bilateral symptoms and self-report of a swollen knee (AUC 0.76). Conclusions The prognosis of non-traumatic knee symptoms in adolescents and young adults in general practice is not as good as was previously assumed. Several prognostic factors collected at baseline were associated with persistent knee symptoms at follow-up. However, the results should be replicated in another larger study.