Trends in Knee Arthroscopy and Subsequent Arthroplasty
Trends in Knee Arthroscopy and Subsequent Arthroplasty
Arthroscopy is an important procedure in orthopaedic surgery, having both diagnostic and therapeutic applications. Knee arthroscopy has become the gold standard in the diagnosis of meniscal and ligamentous injury, and also plays a role in their management. In recent times, the use of knee arthroscopy for the management of osteoarthritis has also become widespread subsequent to studies demonstrating benefit. However, most of these studies were case series or observational in nature and thus do not provide strong evidence. Other studies have questioned the use of knee arthroscopy for degenerative knee disease. Nonetheless, some predictors of successful outcome emerged; younger patients reporting predominantly mechanical symptoms with normally aligned knees and short duration of symptoms were more likely to benefit from arthroscopy.
Recently, three randomised controlled trials provided high level evidence that knee arthroscopy is ineffective in the management of symptomatic osteoarthritis, including those with mechanical symptoms and meniscus tears, compared to placebo or alternative (non-operative) treatment. In light of the disparate effectiveness of arthroscopy for different underlying conditions and age groups, a number of studies have been conducted exploring rates of knee arthroscopy for different age groups and indications. Total Knee Arthroplasty (TKA) within 1–2 years following arthroscopy is viewed as an indicator of lack of effect of the arthroscopic procedure. Studies in other populations have reported conversion rates to TKA within two years following the procedure.
This study was undertaken to describe the age-standardised rates for knee arthroscopy in an Australian population together with the conversion rate to TKA. As the utilisation rates of knee arthroscopy have also been shown to differ according to socioeconomic status, and as access varies between public and private hospitals, we also report the utilisation rates according to hospital status (private versus public).
The utilisation rates of knee arthroscopy and the rate of conversion to TKA subsequent to knee arthroscopy have not yet been described for an Australian cohort, thus, the data will serve as a useful point of reference, and will allow comparison with international rates.
Background
Arthroscopy is an important procedure in orthopaedic surgery, having both diagnostic and therapeutic applications. Knee arthroscopy has become the gold standard in the diagnosis of meniscal and ligamentous injury, and also plays a role in their management. In recent times, the use of knee arthroscopy for the management of osteoarthritis has also become widespread subsequent to studies demonstrating benefit. However, most of these studies were case series or observational in nature and thus do not provide strong evidence. Other studies have questioned the use of knee arthroscopy for degenerative knee disease. Nonetheless, some predictors of successful outcome emerged; younger patients reporting predominantly mechanical symptoms with normally aligned knees and short duration of symptoms were more likely to benefit from arthroscopy.
Recently, three randomised controlled trials provided high level evidence that knee arthroscopy is ineffective in the management of symptomatic osteoarthritis, including those with mechanical symptoms and meniscus tears, compared to placebo or alternative (non-operative) treatment. In light of the disparate effectiveness of arthroscopy for different underlying conditions and age groups, a number of studies have been conducted exploring rates of knee arthroscopy for different age groups and indications. Total Knee Arthroplasty (TKA) within 1–2 years following arthroscopy is viewed as an indicator of lack of effect of the arthroscopic procedure. Studies in other populations have reported conversion rates to TKA within two years following the procedure.
This study was undertaken to describe the age-standardised rates for knee arthroscopy in an Australian population together with the conversion rate to TKA. As the utilisation rates of knee arthroscopy have also been shown to differ according to socioeconomic status, and as access varies between public and private hospitals, we also report the utilisation rates according to hospital status (private versus public).
The utilisation rates of knee arthroscopy and the rate of conversion to TKA subsequent to knee arthroscopy have not yet been described for an Australian cohort, thus, the data will serve as a useful point of reference, and will allow comparison with international rates.
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