No decrease in incidence of arthroscopic meniscectomy in a Canadian province.

Autor: Chan EW; Department of Surgery, University of Saskatchewan College of Medicine, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada. ewc460@mail.usask.ca.; Division of Orthopedic Surgery, University of Saskatchewan College of Medicine, Saskatoon, Canada. ewc460@mail.usask.ca., Chaulk RC; Department of Surgery, University of Saskatchewan College of Medicine, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada., Cheng Y; Department of Surgery, University of Saskatchewan College of Medicine, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada., Shin J; Department of Surgery, University of Saskatchewan College of Medicine, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada.; Division of Orthopedic Surgery, University of Saskatchewan College of Medicine, Saskatoon, Canada.; Dr. F. H. Wigmore Regional Hospital, Moose Jaw, Canada.
Jazyk: angličtina
Zdroj: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA [Knee Surg Sports Traumatol Arthrosc] 2021 Dec; Vol. 29 (12), pp. 4223-4231. Date of Electronic Publication: 2021 Mar 21.
DOI: 10.1007/s00167-021-06534-7
Abstrakt: Purpose: Arthroscopic meniscectomy (APM) is the most common procedure in orthopedic surgery, despite increasing evidence questioning its benefit over conservative management for treatment of degenerative meniscal tears. The purpose of this study is to determine the epidemiology and trends of APM in Saskatchewan, a Canadian province, over a 20 year period.
Methods: Physician billing codes were used to identify patients who underwent APM in Saskatchewan between January 1, 1998 and December 31, 2017. Records were obtained from eHealth Saskatchewan, a provincial health database. Data was analyzed for overall incidence and age-specific trends of APM.
Results: A total of 35,099 APMs were performed during the study period. The population of Saskatchewan ranged from 992,314 to 1,150,782 (median 1,017,368) during this time interval, with 81 orthopedic surgeons performing APM. Overall incidence rate of APM did not change significantly over time. No decrease was observed in patients presumed to have degenerative tears (≥ 50 years). The number of meniscectomies in patients ≥ 50 years was significantly greater during the second decade of study compared to the first (OR 1.48, p < 0.01). Conversely, the increase in incidence rate among older patients was not statistically significant (R 2  = 0.125, n.s.).
Conclusion: Overall incidence rate of APM in Saskatchewan has not decreased during the last 20 years. Furthermore, APM frequency increased over time for individuals ≥ 50 years. Several regional factors may have contributed to these findings, including the large proportion of Saskatchewan residents engaged in physically demanding work and barriers to accessing physiotherapy services. Given recent evidence disputing the benefit of APM over conservative measures, this study highlights the need for improved dissemination of evidence, as well as the importance of an individualized treatment plan to address patient-specific factors.
Level of Evidence: Level IV.
(© 2021. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).)
Databáze: MEDLINE
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