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Trends in knee arthroscopy utilization: a gap in knowledge translation.

Ryan M Degen1, Yekaterina Lebedeva2, Trevor B Birmingham2,3

  • 1Fowler Kennedy Sport Medicine Clinic, Western University, 3M Centre, 1151 Richmond Street, London, ON, N6A 3K7, Canada. Ryan.degen@lhsc.on.ca.

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PubMed
Summary

Despite negative trials, knee arthroscopy use and patient age increased from 2006-2016. This trend highlights a gap in translating evidence into practice, necessitating improved clinical guidelines for knee arthroscopy procedures.

Keywords:
ComplicationsKnee arthroscopyKnowledge translationTrendsUtilization

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Area of Science:

  • Orthopedic Surgery
  • Health Services Research

Background:

  • Knee arthroscopy is a common orthopedic procedure.
  • Evidence suggests limited benefit for certain knee conditions, yet utilization remains high.

Purpose of the Study:

  • To examine trends in knee arthroscopy utilization over time.
  • To assess changes in patient demographics and post-operative complications.
  • To evaluate the impact of negative randomized controlled trials on procedure rates.

Main Methods:

  • Utilized the American College of Surgeons National Surgical Quality Improvement Program database (2006-2016).
  • Analyzed Current Procedural Terminology billing codes for knee arthroscopy cases.
  • Identified and analyzed 30-day post-operative complications and risk factors.

Main Results:

  • Knee arthroscopy rates increased from 0.3% to 1.6% (p < 0.001) between 2006 and 2016.
  • Average patient age increased significantly (p < 0.001), particularly in the partial meniscectomy cohort.
  • Overall complication rate was 2.0%, with common issues including return to OR, DVT/thrombophlebitis, and infection.

Conclusions:

  • Knee arthroscopy utilization and patient age continue to rise despite contrary evidence and guidelines.
  • High procedure volume leads to a significant number of patients experiencing complications.
  • There is a notable gap in the translation of clinical evidence into practice, underscoring the need for better guidelines.