日本における関節鏡視下半月板手術の年間推移：2014年から2023年までの10年間分析

Meniscal surgery is one of the most common procedures in orthopedic surgery. Although several studies suggest an increased risk of osteoarthritis following meniscectomy compared to meniscus repair, surgical decision should consider individual patient's factor, such as tear pattern, age and activity level. Recent national trends in arthroscopic meniscal surgery in Japan remain unclear. This study aimed to analyze the number of meniscal surgeries, and the proportion of meniscal repairs performed between 2014 and 2023.

The Excel files 'Number of calculations by division, sex, and age group'under the 'operation (code K)' from 2014 to 2023 were downloaded from the National Databaseof Health Insurance Claims and Specific Health Checkups of Japan (NDB) Open Data. Thearthroscopic data meniscectomy (code K068-2) and arthroscopic meniscus repair (code K069-3) were analyzed according to demographic characteristics (sex, age). The trend in the number of meniscal surgeries from 2014 to 2023 was examined. The number of surgical procedures performed per year and the incidence of both surgical procedures, calculated as the number performed per 100,000 population per year, were evaluated.

The total number of arthroscopic meniscus surgeries increased from 35,100 cases in 2014 to 49,165 cases in 2023. The total number of arthroscopic meniscus repairs increased from 6652 cases in 2014 to 26,274 cases in 2023. The incidence per 100,000 person-years of arthroscopic meniscus repair also increased from 5.2 in 2014 to 21.1 in 2023. In contrast, the total number of arthroscopic meniscectomy decreased from 28,448 cases in 2014 to 22,891 cases in 2023. The incidence per 100,000 person-years of arthroscopic meniscectomy also decreased from 22.4 in 2014 to 18.4 in 2023. Ratio of arthroscopic meniscus repair significantly increased from 19.0 % in 2014 to 53.4 % in 2023 (p < 0.001). This trend was consistent in both sexes and across age groups. The rate of meniscus repair increased across all age groups (p < 0.001).

From 2014 to 2023 in Japan, the total number of arthroscopic meniscus surgeries increased with a marked rise in the proportion of arthroscopic meniscus repair. This trend was observed across age groups, including in patient over 40.

Level Ⅳ.