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. 2017 Oct 4;18(1):408.
doi: 10.1186/s12891-017-1765-0.

The likelihood of total knee arthroplasty following arthroscopic surgery for osteoarthritis: a systematic review

Amelia R Winter  1 , Jamie E Collins  1   2 , Jeffrey N Katz  3   4   5   6
Affiliations

The likelihood of total knee arthroplasty following arthroscopic surgery for osteoarthritis: a systematic review

Amelia R Winter et al. BMC Musculoskelet Disord. .

Erratum in

Abstract

Background: Arthroscopic surgery is a common treatment for knee osteoarthritis (OA), particularly for symptomatic meniscal tear. Many patients with knee OA who have arthroscopies go on to have total knee arthroplasty (TKA). Several individual studies have investigated the interval between knee arthroscopy and TKA. Our objective was to summarize published literature on the risk of TKA following knee arthroscopy, the duration between arthroscopy and TKA, and risk factors for TKA following knee arthroscopy.

Methods: We searched PubMed, Embase, and Web of Science for English language manuscripts reporting TKA following arthroscopy for knee OA. We identified 511 manuscripts, of which 20 met the inclusion criteria and were used for analysis. We compared the cumulative incidence of TKA following arthroscopy in each study arm, stratifying by type of data source (registry vs. clinical), and whether the study was limited to older patients (≥ 50) or those with more severe radiographic OA. We estimated cumulative incidence of TKA following arthroscopy by dividing the number of TKAs among persons who underwent arthroscopy by the number of persons who underwent arthroscopy. Annual incidence was calculated by dividing cumulative incidence by the mean years of follow-up.

Results: Overall, the annual incidence of TKA after arthroscopic surgery for OA was 2.62% (95% CI 1.73-3.51%). We calculated the annual incidence of TKA following arthroscopy in four separate groups defined by data source (registry vs. clinical cohort) and whether the sample was selected for disease progression (either age or OA severity). In unselected registry studies the annual TKA incidence was 1.99% (95% CI 1.03-2.96%), compared to 3.89% (95% CI 0.69-7.09%) in registry studies of older patients. In unselected clinical cohorts the annual incidence was 2.02% (95% CI 0.67-3.36%), while in clinical cohorts with more severe OA the annual incidence was 4.13% (95% CI 1.81-6.44%). The mean and median duration between arthroscopy and TKA (years) were 3.4 and 2.0 years.

Conclusions: Clinicians and patients considering knee arthroscopy should discuss the likelihood of subsequent TKA as they weigh risks and benefits of surgery. Patients who are older or have more severe OA are at particularly high risk of TKA.

Keywords: Arthroscopic partial meniscectomy; Arthroscopy; Osteoarthritis; Total knee arthroplasty.

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Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare they have no competing interests.

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Figures

Fig. 1
Fig. 1
Search and selection process
Fig. 2
Fig. 2
Mean Annual Incidence of Registry – Unselected, Clinical Cohort – Unselected, Registry – Older Age, and Clinical Cohort – More Severe OA. Each bar represents the estimated yearly incidence of TKA from the logisitc random effects model. The vertical lines represent the 95% confidence intervals
See this image and copyright information in PMC

References

    1. Choong PF, Dowsey MM. Update in surgery for osteoarthritis of the knee. Int J Rheum Dis. 2011;14(2):167–174. doi: 10.1111/j.1756-185X.2011.01617.x. - DOI - PubMed
    1. Dunlop DD, Manheim LM, Yelin EH, Song J, Chang RW. The costs of arthritis. Arthritis Rheum. 2003;49(1):101–113. doi: 10.1002/art.10913. - DOI - PubMed
    1. Deshpande BR, Katz JN, Solomon DH, Yelin EH, Hunter DJ, Messier SP, Suter LG, Losina E. Number of persons with symptomatic knee osteoarthritis in the US: impact of race and ethnicity, age, sex, and obesity. Arthritis Care Res. 2016;68(12):1743–1750. doi: 10.1002/acr.22897. - DOI - PMC - PubMed
    1. Bhattacharyya T, Gale D, Dewire P, Totterman S, Gale ME, McLaughlin S, Einhorn TA, Felson DT. The clinical importance of meniscal tears demonstrated by magnetic resonance imaging in osteoarthritis of the knee. J Bone Joint Surg Am. 2003;85-A(1):4–9. doi: 10.2106/00004623-200301000-00002. - DOI - PubMed
    1. Cullen KA, Hall MJ, Golosinskiy A. Ambulatory surgery in the United States. Natl Health Stat Rep. 2006;2009(11):1–25. - PubMed

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