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Knee arthroscopies: who gets them, what does the radiologist report, and what does the surgeon find?

Bergkvist, Dan LU ; Dahlberg, Leif LU ; Neuman, Paul LU and Englund, Martin LU (2016) In Acta Orthopaedica 87(1). p.12-16
Abstract
Background and purpose - Several randomized controlled trials have not shown any added benefit of arthroscopy over placebo surgery or physiotherapy in middle-aged patients with knee symptoms without trauma. We studied the characteristics of the knee arthroscopies performed in southern Sweden. Patients and methods - From the orthopedic surgical records from 2007-2009 in the Skåne region of Sweden (with a population of 1.2 million), we retrieved ICD-10 diagnostic codes and selected all 4,096 arthroscopies that were diagnosed peroperatively with code M23.2 (derangement of meniscus due to old tear or injury) or code M17 (knee osteoarthritis). We extracted information on cartilage and meniscus status at arthroscopy, and we also randomly sampled... (More)
Background and purpose - Several randomized controlled trials have not shown any added benefit of arthroscopy over placebo surgery or physiotherapy in middle-aged patients with knee symptoms without trauma. We studied the characteristics of the knee arthroscopies performed in southern Sweden. Patients and methods - From the orthopedic surgical records from 2007-2009 in the Skåne region of Sweden (with a population of 1.2 million), we retrieved ICD-10 diagnostic codes and selected all 4,096 arthroscopies that were diagnosed peroperatively with code M23.2 (derangement of meniscus due to old tear or injury) or code M17 (knee osteoarthritis). We extracted information on cartilage and meniscus status at arthroscopy, and we also randomly sampled 502 of these patients from the regional archive of radiology and analyzed the preoperative prevalence of radiographic or magnetic resonance imaging (MRI)-defined osteoarthritis. Results - 2,165 (53%) of the 4,096 arthroscopies had the diagnostic code M23.2 or M17. In this subgroup, 1,375 cases (64%) had typical findings consistent with degenerative meniscal tear (i.e. that correspond to a degenerative meniscal tear in at least a third of all arthroscopies). Of the randomly sampled patients, the preoperative prevalence of radiological knee osteoarthritis was 46%. Interpretation - There is a discrepancy between evidence-based medicine treatment guidelines and clinical practice regarding the amount of knee arthroscopies performed in patients with symptoms of degenerative knee disease. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Orthopaedica
volume
87
issue
1
pages
12 - 16
publisher
Taylor & Francis
external identifiers
  • pmid:26012547
  • wos:000367530700004
  • scopus:84953349692
ISSN
1745-3682
DOI
10.3109/17453674.2015.1055179
language
English
LU publication?
yes
id
6931943c-4737-49e0-8bf0-deea97cc743c (old id 5442190)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/26012547?dopt=Abstract
date added to LUP
2015-06-05 15:21:43
date last changed
2017-11-19 03:11:11
@article{6931943c-4737-49e0-8bf0-deea97cc743c,
  abstract     = {Background and purpose - Several randomized controlled trials have not shown any added benefit of arthroscopy over placebo surgery or physiotherapy in middle-aged patients with knee symptoms without trauma. We studied the characteristics of the knee arthroscopies performed in southern Sweden. Patients and methods - From the orthopedic surgical records from 2007-2009 in the Skåne region of Sweden (with a population of 1.2 million), we retrieved ICD-10 diagnostic codes and selected all 4,096 arthroscopies that were diagnosed peroperatively with code M23.2 (derangement of meniscus due to old tear or injury) or code M17 (knee osteoarthritis). We extracted information on cartilage and meniscus status at arthroscopy, and we also randomly sampled 502 of these patients from the regional archive of radiology and analyzed the preoperative prevalence of radiographic or magnetic resonance imaging (MRI)-defined osteoarthritis. Results - 2,165 (53%) of the 4,096 arthroscopies had the diagnostic code M23.2 or M17. In this subgroup, 1,375 cases (64%) had typical findings consistent with degenerative meniscal tear (i.e. that correspond to a degenerative meniscal tear in at least a third of all arthroscopies). Of the randomly sampled patients, the preoperative prevalence of radiological knee osteoarthritis was 46%. Interpretation - There is a discrepancy between evidence-based medicine treatment guidelines and clinical practice regarding the amount of knee arthroscopies performed in patients with symptoms of degenerative knee disease.},
  author       = {Bergkvist, Dan and Dahlberg, Leif and Neuman, Paul and Englund, Martin},
  issn         = {1745-3682},
  language     = {eng},
  number       = {1},
  pages        = {12--16},
  publisher    = {Taylor & Francis},
  series       = {Acta Orthopaedica},
  title        = {Knee arthroscopies: who gets them, what does the radiologist report, and what does the surgeon find?},
  url          = {http://dx.doi.org/10.3109/17453674.2015.1055179},
  volume       = {87},
  year         = {2016},
}