Clinical Practice and Post-Operative Rehabilitation After Knee Arthroscopy: Comparison Between Polish Experts and Non-Experts.

Abstract

Background: The purpose of this study was to compare the clinical practices between polish expert and non-expert arthroscopy knee surgeons.Methods: 205 registered orthopedic surgeons took part in surveys. The survey included 35 questions regarding general arthroscopy and postoperative management, including physician’s level of expertise, arthroscopy anesthesia, postoperative treatment, rehabilitation and procedures performed. Comparisons were made between knee arthroscopy experts (> 100 arthroscopies performed per year) and non-experts (≤ 100 cases) on aspects of patient care.Results: The most important finding of this study is an agreement in almost all aspects of knee arthroscopy approach. A consensus between polish surgeons was noticed in choosing regional anesthesia for knee arthroscopy, no need for knee braces nor knee medications, using LMW heparin as thromboprophylaxis, 1-2 days hospitalization, recommendation of rehabilitation and magnetic resonance as a diagnostic test for meniscus damage. Surgical expertise was significantly associated with the performance of meniscus sewing procedures (p = 0.009). Experts recommended starting rehabilitation already on the day of surgery (p=0.007) and more likely used objective physical tests (p=0.003). Nonexpert surgeons recommended longer period from meniscus suture to a full range knee motion (p=0.001) and admitted that patient’s age does matter for meniscus repair qualification (0.002).Conclusions: Clinical practice varies among orthopeadists performing knee arthroscopy procedures, based on their level of expertise. Polish knee arthroscopy experts agreed with non-experts in the type of anesthesia during knee arthroscopy and numerous aspects of postoperative treatment. Surgical expertise was associated with the performance of advanced meniscus suturing techniques.