Kang Sang Hyun Samuel, Hwang Annie Yunser, Ho David Ta-Chun, Thangarajah Thirumurugan, Wijenayake Lahann, Parfit Simon, Mclean Andrew, Clayton James
Redland Hospital, Princess Alexandra Hospital, Queensland Children's Hospital, University of Queensland, Queensland Health, Brisbane, QLD, Australia.
BMC Musculoskelet Disord. 2025 Mar 25;26(1):292. doi: 10.1186/s12891-025-08521-2.
In situations of osteoarthritis (OA), the therapeutic value of knee arthroscopy is still a topic of discussion that is ongoing. This study aims to produce data about the relevance of arthroscopy and total knee arthroplasty (TKA) in knee OA by assessing the overall rates of arthroscopy and subsequent conversion to TKA over a two-year period in QLD Australia within the time frame between 2008 and 2023.
A retrospective cohort analysis was undertaken at Queensland (QLD) hospitals that underwent arthroscopy and TKA between 2008 and 2023. Research datasets obtained from the Centre for Health Record Linkage (CHeReL) were analyzed using negative binomial regression. An investigation was performed to determine the rates of arthroscopy admissions by year, age group, sex, and hospital system (public versus private). The TKA readmission rates were calculated during a 24-month period.
The results demonstrate an overall decrease in the frequency of arthroscopies from 2008 to 2022, but total knee arthroplasties (TKA) have increased by 2.79% (95% CI: 2.19 to 3.38). There was a 3.34% reduction in arthroscopy rates at private hospitals and a 0.98% drop at public hospitals (95% CI: -0.26 to 2.23). The largest significant rise in TKA rates was seen in private hospitals. The TKA procedure was performed on 14.48% of patients aged 65 and older within 24 months of knee arthroscopy. After taking sex and age into account, there was a 4.97% reduction in the occurrence of total knee TKA within 24 months following knee arthroscopy (95% CI: -5.55 to -4.40) across the board.
While the rates of TKA are on the rise, arthroscopies and their conversions to TKA are on the decrease. Possible explanations for the persistent drop in TKA conversion rates include better patient selection, more effective non-operative care, or longer wait times for the operation.
在骨关节炎（OA）的情况下，膝关节镜检查的治疗价值仍是一个正在进行讨论的话题。本研究旨在通过评估2008年至2023年期间澳大利亚昆士兰州两年内膝关节镜检查的总体发生率以及随后转为全膝关节置换术（TKA）的情况，得出关于膝关节镜检查和全膝关节置换术（TKA）在膝关节OA中的相关性的数据。
对2008年至2023年期间在昆士兰州医院接受膝关节镜检查和TKA的患者进行回顾性队列分析。使用负二项回归分析从健康记录链接中心（CHeReL）获得的研究数据集。进行调查以确定按年份、年龄组、性别和医院系统（公立与私立）划分的膝关节镜检查入院率。计算24个月期间的TKA再入院率。
结果表明，从2008年到2022年，关节镜检查的频率总体下降，但全膝关节置换术（TKA）增加了2.79%（95%置信区间：2.19至3.38）。私立医院的关节镜检查率下降了3.34%，公立医院下降了0.98%（95%置信区间：-0.26至2.23）。TKA率上升幅度最大的是私立医院。在膝关节镜检查后24个月内，65岁及以上患者中有14.48%接受了TKA手术。在考虑性别和年龄后，膝关节镜检查后24个月内全膝关节TKA的发生率总体下降了4.97%（95%置信区间：-5.55至-4.40）。
虽然TKA的发生率在上升，但关节镜检查及其转为TKA的情况在减少。TKA转化率持续下降的可能原因包括更好的患者选择、更有效的非手术治疗或手术等待时间更长。
