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No decrease in incidence of arthroscopic meniscectomy in a Canadian province
Emily W Chan1,2, Richard C Chaulk3, Yanzhao Cheng3
1Department of Surgery, University of Saskatchewan College of Medicine, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada. ewc460@mail.usask.ca.
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 (R2 = 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.
Insights
Arthroscopic meniscectomy (APM) rates in Saskatchewan remained stable over 20 years, with a notable increase in older patients (≥50 years). This highlights a need for better evidence dissemination and individualized treatment plans for degenerative meniscal tears.
Area of Science:
- Orthopedic Surgery
- Epidemiology
- Public Health
Background:
- Arthroscopic meniscectomy (APM) is a common orthopedic procedure for degenerative meniscal tears.
- Evidence increasingly questions APM's benefit over conservative management.
- Understanding APM trends is crucial for optimizing patient care.
Purpose of the Study:
- To determine the epidemiology and trends of APM in Saskatchewan over a 20-year period.
- To analyze incidence and age-specific trends of APM.
Main Methods:
- Utilized physician billing codes to identify APM procedures in Saskatchewan (1998-2017).
- Obtained data from eHealth Saskatchewan provincial health database.
- Analyzed overall incidence and age-specific trends of APM.
Main Results:
- A total of 35,099 APMs were performed.
- Overall APM incidence rate did not significantly change over time.
- APM frequency increased in patients aged ≥50 years during the second decade (OR 1.48, p<0.01).
Conclusions:
- APM incidence in Saskatchewan has not decreased over the past 20 years.
- APM frequency increased for individuals aged ≥50 years.
- Regional factors and barriers to physiotherapy may influence these trends, necessitating improved evidence dissemination and individualized treatment.
