Our Summary

This study looked at the medical records of patients over 50 with degenerative knee disease who had a surgical procedure called a knee arthroscopy done in the Netherlands in 2016. They wanted to see how many of these procedures were performed without a clear medical reason. Of about 27,000 patients, around 9.5% had an arthroscopy done at one of the 13 orthopedic centers included in the study. They found that for about 35% of these procedures, there was no clear medical reason stated in the patient’s file. This means that the procedure may not have been necessary (known as “low value care”). The main reason given for these procedures was either the patient’s request or a joint decision made by the patient and doctor. The researchers found that factors like the patient’s age, diagnosis, or whether it was their first procedure or a follow-up, didn’t significantly affect the likelihood of an unnecessary arthroscopy being performed. The researchers suggest that guidelines should be developed to help doctors better adhere to when a knee arthroscopy is medically necessary in order to improve patient care.

FAQs

  1. What was the main purpose of the study on knee arthroscopy procedures in the Netherlands?
  2. What percentage of knee arthroscopy procedures in the study were found to have no clear medical reason?
  3. What do researchers suggest to improve patient care and reduce unnecessary knee arthroscopy procedures?

Doctor’s Tip

A helpful tip a doctor might tell a patient about arthroscopy is to make sure they fully understand the reasons for the procedure and to ask any questions they may have before going through with it. It’s important for patients to have a clear understanding of the potential benefits and risks of arthroscopy, as well as alternative treatment options that may be available. Patients should feel empowered to have open and honest discussions with their doctor about their treatment plan to ensure they are receiving the best care possible.

Suitable For

Patients who are typically recommended for arthroscopy are those who have certain conditions or injuries that can be diagnosed and treated through this minimally invasive surgical procedure. Some common reasons for recommending arthroscopy include:

  1. Meniscal tears: A tear in the meniscus, which is the cartilage in the knee joint, can cause pain, swelling, and limited range of motion. Arthroscopy can be used to both diagnose and repair meniscal tears.

  2. Ligament injuries: Tears or strains in the ligaments of the knee, such as the ACL or PCL, can be diagnosed and repaired using arthroscopy.

  3. Cartilage damage: Arthroscopy can be used to diagnose and treat damage to the articular cartilage in the knee joint, which can be caused by conditions such as osteoarthritis or traumatic injury.

  4. Synovitis: Inflammation of the synovial membrane in the knee joint can cause pain and swelling, which can be treated with arthroscopic debridement.

  5. Loose bodies: Small fragments of bone or cartilage that are floating in the joint space can cause pain and limited mobility, and can be removed using arthroscopy.

Overall, arthroscopy is recommended for patients who have persistent knee pain, swelling, or limited mobility that has not responded to conservative treatments such as physical therapy or medication. It is important for patients to discuss their symptoms and treatment options with their healthcare provider to determine if arthroscopy is the right course of action for their specific condition.

Timeline

Before arthroscopy:

  1. Patient experiences knee pain, swelling, or stiffness
  2. Patient visits a doctor or orthopedic specialist for evaluation
  3. Doctor recommends arthroscopy as a potential treatment option
  4. Patient undergoes pre-operative testing and preparation
  5. Arthroscopy procedure is scheduled

After arthroscopy:

  1. Patient undergoes arthroscopy procedure under anesthesia
  2. Recovery period begins with physical therapy and pain management
  3. Patient follows post-operative instructions for rest and rehabilitation
  4. Follow-up appointments with the doctor to monitor progress and address any concerns
  5. Patient gradually resumes normal activities with improved knee function and reduced pain
  6. Long-term monitoring to assess the effectiveness of the arthroscopy in improving knee function and quality of life.

What to Ask Your Doctor

  1. Is arthroscopy the best treatment option for my condition?
  2. What are the potential risks and complications associated with arthroscopy?
  3. What is the expected recovery time after arthroscopy?
  4. How long will the benefits of arthroscopy last?
  5. Are there any alternative treatments to arthroscopy that I should consider?
  6. How many arthroscopies have you performed for this specific condition?
  7. What is your success rate with arthroscopy for patients with similar conditions?
  8. What are the specific reasons why you recommend arthroscopy for me?
  9. Will I need any additional treatments or therapies after arthroscopy?
  10. Are there any specific guidelines or criteria that you follow when recommending arthroscopy for patients?

Reference

Authors: Rietbergen T, Marang-van de Mheen PJ, Diercks RL, Janssen RPA, van der Linden-van der Zwaag HMJ, Nelissen RGHH, Steyerberg EW, van Bodegom-Vos L; SMART study group. Journal: Knee Surg Sports Traumatol Arthrosc. 2022 May;30(5):1568-1574. doi: 10.1007/s00167-021-06615-7. Epub 2021 Jun 19. PMID: 34146116