Analysis of the Incidence of Knee Arthroscopy, Total Knee Arthroplasty (TKA), and Readmission Rates for TKA After Previous Knee Arthroscopy in the Queensland (QLD) Population.

IF 2.2 3区 医学 Q2 ORTHOPEDICS
Sang Hyun Samuel Kang, Annie Yunser Hwang, David Ta-Chun Ho, Thirumurugan Thangarajah, Lahann Wijenayake, Simon Parfit, Andrew Mclean, James Clayton
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引用次数: 0

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

背景:在骨关节炎(OA)的情况下,膝关节镜的治疗价值仍是一个持续讨论的话题。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关节镜检查和随后转为全膝关节置换术(TKA)的总体比率,得出膝关节 OA 中关节镜检查和全膝关节置换术(TKA)的相关性数据:对昆士兰州(QLD)2008年至2023年期间接受关节镜手术和TKA的医院进行了回顾性队列分析。采用负二项回归法分析了从健康记录链接中心(CHeReL)获得的研究数据集。调查按年份、年龄组、性别和医院系统(公立与私立)确定了关节镜手术入院率。计算了 24 个月内的 TKA 再入院率:结果表明,从2008年到2022年,关节镜手术的频率总体下降,但全膝关节置换术(TKA)增加了2.79%(95% CI:2.19至3.38)。私立医院的关节镜手术率下降了 3.34%,公立医院下降了 0.98%(95% CI:-0.26 至 2.23)。私立医院的 TKA 率上升幅度最大。在膝关节镜检查后的 24 个月内,14.48% 的 65 岁及以上患者接受了 TKA 手术。考虑性别和年龄因素后,膝关节镜检查后24个月内进行全膝关节TKA手术的比例下降了4.97%(95% CI:-5.55至-4.40):虽然全膝关节置换术的比例在上升,但关节镜手术及其转为全膝关节置换术的比例却在下降。TKA转化率持续下降的可能原因包括患者选择更合理、非手术治疗更有效或手术等待时间更长。
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来源期刊
BMC Musculoskeletal Disorders
BMC Musculoskeletal Disorders 医学-风湿病学
CiteScore
3.80
自引率
8.70%
发文量
1017
审稿时长
3-6 weeks
期刊介绍: BMC Musculoskeletal Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of musculoskeletal disorders, as well as related molecular genetics, pathophysiology, and epidemiology. The scope of the Journal covers research into rheumatic diseases where the primary focus relates specifically to a component(s) of the musculoskeletal system.
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