Abstract:Background Multiple clinical trials have shown that arthroscopy for knee osteoarthritis is not efficacious. It is unclear how these studies have affected orthopaedic practice in the USA. Questions/purposes We questioned whether, in the Veterans Health Administration system, rates of knee arthroscopy in patients with osteoarthritis have changed after publication of the initial clinical trial by Moseley et al. in 2002, and whether rates of arthroplasty within 2 years of arthroscopy have changed during the same p… Show more
“…Patient-indication measures have a denominator including only patients that had the potential to receive the service. For example, a cohort of patients with osteoarthritis with a knee arthroscopy rate of 4% is a patient-indication measure since only patients with osteoarthritis are included in the denominator 11. A patient-population measure denominator includes the entire cohort, such as the result reported by Schwartz, et al,
12 where the percentage of all Medicare beneficiaries with both a knee arthroscopy and osteoarthritis diagnosis was 0.2%.…”
Section: Patient and Service Type Measures Of Low-value Carementioning
“…Patient-indication measures have a denominator including only patients that had the potential to receive the service. For example, a cohort of patients with osteoarthritis with a knee arthroscopy rate of 4% is a patient-indication measure since only patients with osteoarthritis are included in the denominator 11. A patient-population measure denominator includes the entire cohort, such as the result reported by Schwartz, et al,
12 where the percentage of all Medicare beneficiaries with both a knee arthroscopy and osteoarthritis diagnosis was 0.2%.…”
Section: Patient and Service Type Measures Of Low-value Carementioning
“…Shoulder arthroscopy rates have increased by 55% between 2001 and 2013 despite a lack of supporting evidence 8. In the US Veterans Health Administration system, 4% of individuals with knee osteoarthritis undergo knee arthroscopy annually, although there is limited clinical benefit 9. These practices are problematic because at best they represent ineffective, expensive and inefficient care, and at worst, they serve to increase the burden of MSK pain.…”
Objectives Undertake a systematic critical appraisal of contemporary clinical practice guidelines (CPGs) for common musculoskeletal (MSK) pain conditions: spinal (lumbar, thoracic and cervical), hip/knee (including osteoarthritis) and shoulder.
“…Despite increased emphasis on evidence-based medicine in both training and practice, and growing awareness of the need for good stewardship of healthcare resources, the use of these low-value orthopaedic interventions continues. Spending on viscosupplementation continues to grow [15,23], the rate of knee arthroscopy in patients with osteoarthritis has remained stable in the Veterans Administration system [2], and complex spinal fusion rates among patients with Medicare have increased markedly [11].…”
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