Evaluation of Trends in Knee Arthroscopy from 2004 to 2019 in Ontario, Canada

Is Arthroscopic Meniscectomy Associated With an Increased Risk of Total Knee Arthroplasty for Claimants in the Workers’ Compensation System? A 10-Year Study of Workers’ Compensation Claims From a Large Nationwide Workers’ Compensation Insurance Carrier

“…This would seem to indicate that changes in the medical practice of physicians treating workers covered by WC do not reflect changes occurring in medical practice in most non-WC populations covered by other forms of insurance. 26,37,38 In summary, this WC claim study confirms some results that have been previously reported, namely, that (1) AM as well as age increases the risk of a subsequent TKA (similar to the results on non-WC populations), ( 2) younger age at injury and undergoing an AM predicts a greater chance of a subsequent TKA, and (3) coverage under WC influences the surgical indications for AM and TKA. Unique findings in this study are the investigations' demonstration of the relationship of claimant attorney representation to higher rates of progression to TKA after AM.…”

“…37 Similar changes have been observed in Finland. 38 Unlike recent general populations studies, 37,38 we did not observe an annual decrease in the frequency of TKA post AM in the WC population we investigated. 37,38 As indicated previously, the frequency and percent of TKAs to all knee arthroscopy claims in the inventory varied roughly 5% each year and the proportion of TKAs with prior AM increased from 2.81% to 3.57% between injury years 2007 to 2017.…”

“…This study stimulated other investigators [21][22][23]25,26,36 to question the efficacy of AM in the milieu of osteoarthritis. Consequently, Rampersaud et al, 37 patients with an initial diagnosis of osteoarthritis and degenerative meniscus disease in those diagnosis codes. 37 Similar changes have been observed in Finland.…”

“…Consequently, Rampersaud et al, 37 patients with an initial diagnosis of osteoarthritis and degenerative meniscus disease in those diagnosis codes. 37 Similar changes have been observed in Finland. 38 Unlike recent general populations studies, 37,38 we did not observe an annual decrease in the frequency of TKA post AM in the WC population we investigated.…”

“…This study stimulated other investigators 21–23,25,26,36 to question the efficacy of AM in the milieu of osteoarthritis. Consequently, Rampersaud et al, 37 in Canada, reported an 8.9% decrease in knee arthroscopies between 2004–2005 and 2018–2019 with the volume for arthroscopies for osteoarthritis declining 77.9% between 2007–2008 and 2018–2019. They also reported that arthroscopies for degenerative meniscal disorders declined by 34.6% between 2013–2014 and 2018–2019.…”