Department of Surgery, University of Saskatchewan College of Medicine, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada.
Division of Orthopedic Surgery, University of Saskatchewan College of Medicine, Saskatoon, Canada.
Knee Surg Sports Traumatol Arthrosc. 2021 Dec;29(12):4223-4231. doi: 10.1007/s00167-021-06534-7. Epub 2021 Mar 21.
Arthroscopic meniscectomy (APM) is the most common procedure in orthopedic surgery, despite increasing evidence questioning its benefit over conservative management for treatment of degenerative meniscal tears. The purpose of this study is to determine the epidemiology and trends of APM in Saskatchewan, a Canadian province, over a 20 year period.
Physician billing codes were used to identify patients who underwent APM in Saskatchewan between January 1, 1998 and December 31, 2017. Records were obtained from eHealth Saskatchewan, a provincial health database. Data was analyzed for overall incidence and age-specific trends of APM.
A total of 35,099 APMs were performed during the study period. The population of Saskatchewan ranged from 992,314 to 1,150,782 (median 1,017,368) during this time interval, with 81 orthopedic surgeons performing APM. Overall incidence rate of APM did not change significantly over time. No decrease was observed in patients presumed to have degenerative tears (≥ 50 years). The number of meniscectomies in patients ≥ 50 years was significantly greater during the second decade of study compared to the first (OR 1.48, p < 0.01). Conversely, the increase in incidence rate among older patients was not statistically significant (R = 0.125, n.s.).
Overall incidence rate of APM in Saskatchewan has not decreased during the last 20 years. Furthermore, APM frequency increased over time for individuals ≥ 50 years. Several regional factors may have contributed to these findings, including the large proportion of Saskatchewan residents engaged in physically demanding work and barriers to accessing physiotherapy services. Given recent evidence disputing the benefit of APM over conservative measures, this study highlights the need for improved dissemination of evidence, as well as the importance of an individualized treatment plan to address patient-specific factors.
Level IV.
关节镜下半月板切除术（APM）是矫形外科最常见的手术，尽管越来越多的证据对其在退行性半月板撕裂的治疗中优于保守治疗提出了质疑。本研究的目的是确定在加拿大萨斯喀彻温省（Saskatchewan）进行 APM 的流行病学和趋势，研究时间跨度为 20 年。
使用医师计费代码来确定 1998 年 1 月 1 日至 2017 年 12 月 31 日期间在萨斯喀彻温省进行 APM 的患者。记录从省级健康数据库 eHealth Saskatchewan 中获取。对 APM 的总体发生率和年龄特异性趋势进行数据分析。
在研究期间共进行了 35099 例 APM。在此期间，萨斯喀彻温省的人口范围从 992314 人到 1150782 人（中位数为 1017368 人），有 81 名矫形外科医生进行 APM。APM 的总体发生率随时间变化无显著变化。对于假定患有退行性撕裂（≥50 岁）的患者，未观察到下降。与研究的第一个十年相比，在研究的第二个十年中，≥50 岁患者的半月板切除术数量明显增加（OR 1.48，p<0.01）。相反，老年患者的发生率增加不具有统计学意义（R=0.125，n.s.）。
在过去的 20 年中，萨斯喀彻温省 APM 的总体发生率并未下降。此外，对于≥50 岁的人群，APM 的频率随时间增加。一些地区因素可能导致了这些发现，包括从事体力劳动的萨斯喀彻温省居民比例较大，以及获得物理治疗服务的障碍。鉴于最近有证据质疑 APM 优于保守治疗，本研究强调需要更好地传播证据，以及制定针对患者特定因素的个体化治疗计划的重要性。
IV 级。
