Temporal trends and regional variation in the rate of arthroscopic knee surgery in England: analysis of over 1.7 million procedures between 1997 and 2017. Has practice changed in response to new evidence?

ObjectivesWe investigated trends and regional variation in the rate of arthroscopic knee surgery performed in England from 1997–1998 to 2016–2017.DesignCross-sectional study of the national hospital episode statistics (HES) for England.MethodsAll hospital episodes for patients undergoing a knee arthroscopy between 1 April 1997 and 31 March 2017 were extracted from HES by procedure code. Age and sex-standardised rates of surgery were calculated using Office for National Statistic population data as the denominator. Trends in the rate of surgery were analysed by procedure both nationally and by Clinical Commissioning Group (CCG).ResultsA total of 1 088 872 arthroscopic partial meniscectomies (APMs), 326 600 diagnostic arthroscopies, 308 618 knee washouts and 252 885 chondroplasties were identified (1 759 467 hospital admissions; 1 447 142 patients). The rate of APM increased from a low of 51/100 000 population (95% CI 51 to 52) in 1997–1998 to a peak at 149/100 000 (95% CI 148 to 150) in 2013–2014; then, after 2014–2015, rates declined to 120/100 000 (95% CI 119 to 121) in 2016–2017. Rates of arthroscopic knee washout and diagnostic arthroscopy declined steadily from 50/100 000 (95% CI 49 to 50) and 47/100 000 (95% CI 46 to 47) respectively in 1997–1998, to 4.8/100 000 (95% CI 4.6 to 5.0) and 8.1/100 000 (95% CI 7.9 to 8.3) in 2016–2017. Rates of chondroplasty have increased from a low of 3.2/100 000 (95% CI 3.0 to 3.3) in 1997–1998 to 51/100 000 (95% CI 50.6 to 51.7) in 2016–2017. Substantial regional and age–group variation in practice was detected. In 2016–2017, between 11% (22/207) and 16% (34/207) of CCGs performed at least double the national average rate of each procedure.ConclusionsOver the last 20 years, and likely in response to new evidence, rates of arthroscopic knee washout and diagnostic arthroscopy have declined by up to 90%. APM rates increased about 130% overall but have declined recently. Rates of chondroplasty increased about 15-fold. There is significant variation in practice, but the appropriate population intervention rate for these procedures remains unknown.

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Does Blood Flow Restriction Training Improve Quadriceps Measures After Arthroscopic Knee Surgery? A Critically Appraised Topic

International Journal of Athletic Therapy & Training ◽

10.1123/ijatt.2019-0076 ◽

2020 ◽

Vol 25 (5) ◽

pp. 221-226

Author(s):

Erik H. Arve ◽

Emily Madrak ◽

Aric J. Warren

Keyword(s):

Blood Flow ◽

Cross Sectional Area ◽

Knee Surgery ◽

Blood Flow Restriction ◽

Sectional Area ◽

Bottom Line ◽

Cross Sectional ◽

Arthroscopic Knee Surgery ◽

Flow Restriction ◽

Arthroscopic Knee

Focused Clinical Question: Is there evidence to suggest that blood flow restriction (BFR) training improves strength, cross-sectional area, and thigh girth of the quadriceps musculature in patients after arthroscopic surgical procedures of the knee? Clinical Bottom Line: There is moderate consistent, but low-level, evidence supporting the use of BFR training to improve knee extensor muscular outcomes (strength, cross-sectional area, and/or thigh girth) immediately after arthroscopic knee surgery.

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Faculty Opinions recommendation of Intra-articular magnesium is effective for postoperative analgesia in arthroscopic knee surgery.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.30416.486915 ◽

2006 ◽

Author(s):

Gordon Drummond

Keyword(s):

Postoperative Analgesia ◽

Knee Surgery ◽

Arthroscopic Knee Surgery ◽

Arthroscopic Knee

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Intra-articular magnesium to alleviate postoperative pain after arthroscopic knee surgery: a meta-analysis of randomized controlled trials

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02264-1 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Lijun Shi ◽

Haiyun Zhu ◽

Jinhui Ma ◽

Li-Li Shi ◽

Fuqiang Gao ◽

...

Keyword(s):

Postoperative Pain ◽

Randomized Controlled Trials ◽

Pain Intensity ◽

Opioid Consumption ◽

Knee Surgery ◽

Cochrane Library ◽

Controlled Trials ◽

Arthroscopic Knee Surgery ◽

Randomized Controlled ◽

Arthroscopic Knee

Abstract Objective We aimed to evaluate the safety and efficacy of intra-articular (IA) magnesium (Mg) for postoperative pain relief after arthroscopic knee surgery. Methods We searched PubMed, Embase, Medline, Cochrane library, and Web of Science to identify randomized controlled trials that compared postoperative pain outcomes with or without IA Mg after knee arthroscopy. The primary outcomes were pain intensity at rest and with movement at different postoperative time points and cumulative opioid consumption within 24 h after surgery. Secondary outcomes included the time to first analgesic request and side effects. Results In total, 11 studies involving 677 participants met the eligibility criteria. Pain scores at rest and with movement 2, 4, 12, and 24 h after surgery were significantly lower, doses of supplementary opioid consumption were smaller, and the time to first analgesic requirement was longer in the IA Mg group compared with the control group. No significant difference was detected regarding adverse reactions between the groups. Conclusions Intra-articular magnesium is an effective and safe coadjuvant treatment for relieving postoperative pain intensity after arthroscopic knee surgery. Protocol registration at PROSPERO: CRD42020156403.

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Clinical analgesic efficacy and side effects of dexmedetomidine in the early postoperative period after arthroscopic knee surgery

Journal of Clinical Anesthesia ◽

10.1016/j.jclinane.2007.06.013 ◽

2007 ◽

Vol 19 (8) ◽

pp. 576-582 ◽

Cited By ~ 29

Author(s):

Maria E. Gómez-Vázquez ◽

Eduardo Hernández-Salazar ◽

Abel Hernández-Jiménez ◽

Arturo Pérez-Sánchez ◽

Vilma A. Zepeda-López ◽

...

Keyword(s):

Side Effects ◽

Postoperative Period ◽

Analgesic Efficacy ◽

Early Postoperative Period ◽

Knee Surgery ◽

Arthroscopic Knee Surgery ◽

Arthroscopic Knee

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Endovascular repair of a pseudoaneurysm of the popliteal artery following arthroscopic knee surgery: case report and review of literature

Vascular ◽

10.1177/1708538113477799 ◽

2013 ◽

Vol 21 (2) ◽

pp. 102-104 ◽

Cited By ~ 5

Author(s):

Zachary Aburahma ◽

Stephen M Hass

Keyword(s):

Case Report ◽

Endovascular Repair ◽

Popliteal Artery ◽

Knee Surgery ◽

Review Of Literature ◽

Safe Alternative ◽

Arthroscopic Knee Surgery ◽

Arthroscopic Knee

We report a case of a pseudoaneurysm of the popliteal artery following arthroscopic knee surgery. Endovascular repair was successfully used as the treatment for this patient and studies have shown this to be a safe alternative to surgery.

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