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Rate of knee arthroscopy declined between 2002 and 2015

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A research letter published in JAMA Internal Medicine revealed a decline in the rate of knee arthroscopy in Florida between 2002 and 2015, with this decline especially pronounced after 2008.

Using the Florida State Ambulatory Surgery and State Inpatient Databases, David H. Howard, PhD, evaluated trends in outpatient arthroscopic knee procedures among patients aged 18 years or older between 2000 to 2015. To gauge the possible substitution between knee arthroplasty and arthroscopy, Howard identified trends in the use of total knee arthroplasties. He also separately examined the trends in arthroscopic knee procedures by age group.

Between 2002 and 2015, Howard found 868,482 arthroscopic knee procedures were performed in Florida, of which 81.1% of the procedures were meniscectomies. Results showed a decrease in the rate of knee arthroscopy from 449 procedures per 100,000 population aged 18 years or older in 2002 to 345 procedures in 2015. Howard also noted a decline in the meniscectomy rate from 349 in 2002 to 291 in 2015, as well as an increase in the adjusted knee arthroplasty rate from 170 in 2002 to 244 in 2015. However, Howard found a decline in the rate of adjusted knee arthroscopy from 447 in 2002 to 339 in 2015 and from 454 in 2002 to 368 in 2015 among patients aged 18 to 64 years and patients aged 65 years or older, respectively.

“Many experts are skeptical that doctors modify the way they treat patients in response to evidence, especially when trials show that widely used treatments do not work. Knee arthroscopy is often cited as an example,” Howard told Healio.com/Orthopedics. “However, I show that evidence has made a difference. Use of arthroscopic has declined. I do not know why, whether it is driven by patients, physicians or insurers. In this case, there have been multiple trials that have reached the same conclusion. My study shows the value of subjecting widely used by untested treatments to trials.” – by Casey Tingle

Reference:

Howard DH. JAMA Intern Med. 2018;doi:10.1001/jamainternmed.2018.4175.

Disclosure: Howard reports no relevant financial disclosures.