Despite Increase in Osteoarthritis, Knee Arthroscopy on the Decline in Adults

Adults with torn cartilage or arthritis in their knee are becoming less likely to undergo knee arthroscopy, a new study has found. 

Study author Dr. David Howard used the Florida State Ambulatory Surgery and State Inpatient Databases for 2000 to 2015 to collect data on surgeries performed on patients aged ≥ 18 years in the state. Between 2002 and 2015, 868,482 knee arthroscopies were performed, 81.1% of which were meniscectomies (n = 704,563). The number of knee arthroscopies went from 449 per 100,000 population aged ≥ 18 years in 2002 to 345 per 100,000 in 2015 (change, 23%; P < .001). The meniscectomy rate also went down from 349 in 2002 to 291 in 2015 (change, 17%; P = .002). The adjusted rate of knee arthroplasties increased during the study period, from 170 to 244 (change, 44%; P < .001). 

News in brief: Declining rates of knee #arthroscopy in a US population, but it remains a common procedure. Read more in the @JAMAInternalMed research letter by David Howard (@EmoryUniversity) https://t.co/nw1TGLSiaN #osteoarthritis

— medwireNews (@medwireNews) September 27, 2018

The most pronounced decline was after 2008, at which time the New England Journal of Medicine published a study that found no additional benefit to physical and medical therapy for knee osteoarthritis patients following arthroscopic surgery. The increase in arthroplasties primarily took place prior to the decline in arthroscopies, Howard noted in the current study. 

A conversation with Dr. David Howard of @EmoryUniversity regarding his study and findings on why the number of knee arthroscopic procedures have declined: https://t.co/bwVSc24PET via @medresearchnews pic.twitter.com/CicNUQAJpE

— OREF (@OREFtoday) September 26, 2018

The declines took place even though osteoarthritis rates climbed among adults nationwide from 6.6% in 1999 to 14.3% in 2014, Howard wrote. 

“There was some evidence that use of arthroscopy was declining, but this study shows that the decline was large and has been sustained,” Howard told Reuters by email. “I think patients can be reassured that doctors reacted to the evidence.” 

Read about the link between knee osteoarthritis and obesity here. 

Losing Weight with Knee Osteoarthritis: More is Better 

Bisphosphonates: a therapeutic option for knee osteoarthritis?

Sources: JAMA, Reuters