Increase in Outpatient Knee Arthroscopy in the United States: A Comparison of National Surveys of Ambulatory Surgery, 1996 and 2006
Increase in Outpatient Knee Arthroscopy in the United States: A Comparison of National Surveys of Ambulatory Surgery, 1996 and 2006
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DOI：
10.2106/jbjs.i.01618
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发表时间：
2011-06-01
影响因子：
5.3
通讯作者：
Marder, Richard
中科院分区：
文献类型：
--
作者：
Kim, Sunny;Bosque, Jose;Marder, Richard
背景资料：这项研究提出了调查的变化，利用膝关节镜在门诊设置在过去的十年中，在美国，以及其implications.Methods：全国门诊手术调查，最后一次在1996年进行的，在2006年再次由疾病控制和预防中心。我们分析了手术编码指示膝关节镜或前交叉韧带重建的病例。为了估计所有膝关节镜手术在美国每年的门诊设置，我们进行了基于设计的统计analysis.Results：膝关节镜手术的数量增加了49%，1996年和2006年之间。虽然膝关节损伤的关节镜手术数量急剧增加，但膝关节骨关节炎的关节镜手术数量减少。1996年，在独立的门诊手术中心进行的膝关节镜手术仅占所有骨科手术的15%，但这一比例在2006年增加到51%。无论性别，中年患者的膝关节镜检查都有大幅增加。2006年，超过99%的膝关节镜手术是在门诊进行的。2006年在门诊环境中进行了约984，607例膝关节关节镜手术（95%置信区间，895，999 - 1，073，215）。其中，127，446例手术（95%置信区间，95，124 - 159，768）用于前交叉韧带重建。近500，000关节镜手术进行了内侧或外侧tarecal tears.Conclusions：这项研究表明，在美国的膝关节镜手术率是两倍以上，比在英格兰或安大略，加拿大，在2006年。我们的研究发现，近一半的膝关节镜手术用于治疗膝关节撕裂。半月板损伤，通过磁共振成像检测，通常被认为是疼痛和症状的来源。进一步的研究是必要的，以更好地确定症状，身体检查结果和影像学检查结果，是成功的关节镜治疗的预测。
Background: This study was proposed to investigate the changes in the utilization of knee arthroscopy in an ambulatory setting over the past decade in the United States as well as its implications.Methods: The National Survey of Ambulatory Surgery, last carried out in 1996, was conducted again in 2006 by the Centers for Disease Control and Prevention. We analyzed the cases with procedure coding indicative of knee arthroscopy or anterior cruciate ligament reconstruction. To produce estimates for all arthroscopic procedures on the knee in an ambulatory setting in the United States for each year, we performed a design-based statistical analysis.Results: The number of arthroscopic procedures on the knee increased 49% between 1996 and 2006. While the number of arthroscopic procedures for knee injury had dramatically increased, arthroscopic procedures for knee osteoarthritis had decreased. In 1996, knee arthroscopies performed in freestanding ambulatory surgery centers comprised only 15% of all orthopaedic procedures, but the proportion increased to 51% in 2006. There was a large increase in knee arthroscopy among middle-aged patients regardless of sex. In 2006, >99% of arthroscopic procedures on the knee were in an outpatient setting. Approximately 984,607 arthroscopic procedures on the knee (95% confidence interval, 895,999 to 1,073,215) were performed in an outpatient setting in 2006. Among those, 127,446 procedures (95% confidence interval, 95,124 to 159,768) were for anterior cruciate ligament reconstruction. Nearly 500,000 arthroscopic procedures were performed for medial or lateral meniscal tears.Conclusions: This study revealed that the knee arthroscopy rate in the United States was more than twofold higher than in England or Ontario, Canada, in 2006. Our study found that nearly half of the knee arthroscopic procedures were performed for meniscal tears. Meniscal damage, detected by magnetic resonance imaging, is commonly assumed to be the source of pain and symptoms. Further study is imperative to better define the symptoms, physical findings, and radiographic findings that are predictive of successful arthroscopic treatment.