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Trends in the Use of Knee Arthroscopy in Adults

Educational Objective
To review the trends of Knee Arthroscopy in Adults
1 Credit CME

Multiple clinical trials have shown that knee arthroscopy, compared with medical management, does not result in clinically significant benefits for patients with osteoarthritis, meniscal tears, and knee pain.1,2 It is unclear whether these trials have affected clinical practice. Reimbursement incentives favor surgery, and surgeons’ and patients’ beliefs may not reflect the evidence.3 In this article, I document the trends in the use of knee arthroscopy in Florida from January 1, 2002, to December 31, 2015.

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Article Information

Accepted for Publication: June 16, 2018.

Corresponding Author: David H. Howard, PhD, Department of Health Policy and Management, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322 (david.howard@emory.edu).

Published Online: September 24, 2018. doi:10.1001/jamainternmed.2018.4175

Conflict of Interest Disclosures: None reported.

References
1.
Khan  M, Evaniew  N, Bedi  A, Ayeni  OR, Bhandari  M.  Arthroscopic surgery for degenerative tears of the meniscus: a systematic review and meta-analysis.  CMAJ. 2014;186(14):1057-1064. doi:10.1503/cmaj.140433PubMedGoogle ScholarCrossref
2.
Thorlund  JB, Juhl  CB, Roos  EM, Lohmander  LS.  Arthroscopic surgery for degenerative knee: systematic review and meta-analysis of benefits and harms.  BMJ. 2015;350:h2747. doi:10.1136/bmj.h2747PubMedGoogle ScholarCrossref
3.
Barlow  T, Plant  CE.  Why we still perform arthroscopy in knee osteoarthritis: a multi-methods study.  BMC Musculoskelet Disord. 2015;16:85. doi:10.1186/s12891-015-0537-yPubMedGoogle ScholarCrossref
4.
Howard  D, Brophy  R, Howell  S.  Evidence of no benefit from knee surgery for osteoarthritis led to coverage changes and is linked to decline in procedures.  Health Aff (Millwood). 2012;31(10):2242-2249. doi:10.1377/hlthaff.2012.0644PubMedGoogle ScholarCrossref
5.
Kirkley  A, Birmingham  TB, Litchfield  RB,  et al.  A randomized trial of arthroscopic surgery for osteoarthritis of the knee.  N Engl J Med. 2008;359(11):1097-1107. doi:10.1056/NEJMoa0708333PubMedGoogle ScholarCrossref
6.
Park  J, Mendy  A, Vieira  ER.  Various types of arthritis in the United States: prevalence and age-related trends from 1999 to 2014.  Am J Public Health. 2018;108(2):256-258. doi:10.2105/AJPH.2017.304179PubMedGoogle ScholarCrossref
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