2000 年至 2011 年,丹麦中年和老年人群中关节镜半月板手术大幅增加。
Large increase in arthroscopic meniscus surgery in the middle-aged and older population in Denmark from 2000 to 2011.
机构信息
Department of Sports Science and Clinical Biomechanics , University of Southern Denmark , Odense.
出版信息
Acta Orthop. 2014 Jun;85(3):287-92. doi: 10.3109/17453674.2014.919558. Epub 2014 May 6.
BACKGROUND
Arthroscopic meniscal surgery is the most common orthopedic procedure, and the incidence has increased in Denmark over the last 10 years. Concomitantly, several randomized controlled trials have shown no benefit of arthroscopic procedures including arthroscopic partial meniscectomy in middle-aged and older individuals suffering from knee pain with or without knee osteoarthritis. We examined the annual incidence of meniscal procedures together with age, sex, and diagnosis for patients who underwent meniscal procedures in the period 2000-2011 in Denmark.
METHODS
Data on age, sex, diagnosis, and surgical procedures were extracted from the Danish National Patient Register for the years 2000-2011, for all records containing meniscal surgery as a primary or secondary procedure.
RESULTS
The overall annual incidence of meniscal procedures per 100,000 persons in Denmark doubled from 164 in 2000 to 312 in 2011 (i.e. 8,750 procedures to 17,368 procedures). A 2-fold increase was found for patients aged between 35 and 55, and a 3-fold increase was found for those older than 55. Middle-aged and older patients accounted for 75% of all 151,228 meniscal procedures carried out between 2000 and 2011.
INTERPRETATION
The incidence of meniscal procedures performed in Denmark doubled from 2000 to 2011, with the largest increase in middle-aged and older patients. This increase contrasts with the mounting evidence showing no added benefit of arthroscopic partial meniscectomy over non-surgical treatments. Our observations illustrate the long delay in the dissemination, acceptance, and implementation of research evidence into the practice of arthroscopic surgery.
背景
关节镜半月板手术是最常见的骨科手术,在过去 10 年中,丹麦的发病率有所增加。与此同时,几项随机对照试验表明,对于患有膝关节疼痛伴或不伴骨关节炎的中年和老年人,关节镜手术(包括关节镜部分半月板切除术)没有益处。我们检查了 2000 年至 2011 年期间在丹麦接受半月板手术的患者的半月板手术的年发病率,以及年龄、性别和诊断。
方法
从丹麦国家患者登记处提取了 2000 年至 2011 年所有包含半月板手术作为主要或次要手术的患者的年龄、性别、诊断和手术程序的数据。
结果
丹麦半月板手术的总年发病率(每 10 万人中 164 例增加到 2011 年的 312 例)增加了一倍(即从 8750 例增加到 17368 例)。35 至 55 岁之间的患者增加了两倍,55 岁以上的患者增加了三倍。中年和老年患者占 2000 年至 2011 年期间进行的 151228 例半月板手术的 75%。
解释
丹麦进行的半月板手术的发病率从 2000 年到 2011 年增加了一倍,其中中年和老年患者的增加幅度最大。这种增加与越来越多的证据表明,关节镜部分半月板切除术与非手术治疗相比没有额外的益处相矛盾。我们的观察结果说明了研究证据在关节镜手术实践中的传播、接受和实施存在很长的延迟。