Painful medial knee compartment syndrome in over-45 year-olds: I – Medical or surgical management: a series of 174 patients

Andro, C.; Dubrana, F.; Marcillaud, G.; Rouvillain, J.-L.; Gunepin, François-Xavier; Dewerpe, P.; Guilbert, S.; Wessely, L.; Buisson, P.; Chicault, P.; Nguyen-Khanh, J.-P.; Brune, T.; Dhénain, Marc; Maugars, Yves

doi:10.1016/j.otsr.2011.03.004

Cited by 3 publications

(3 citation statements)

References 18 publications

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“…It would have been interesting to determine whether the meniscectomy procedures were become increasingly sparing over the years by determining the percentage of tissue removed; • we did not have access to the age breakdown within the various regions of France. Thus, it is impossible at this stage to claim the populations within these regions are comparable; • lastly, since the medical treatment associated with surgical abstention (non-surgical treatment) has taken an important role in treating degenerative meniscal lesions [19], we could not follow how it changed given that this study focused on surgical procedures. A prospective multicenter study would not get around these limitations as it would induce a major selection bias and would not be representative of the general population.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the trends in arthroscopic meniscectomy and meniscus repair procedures in France from 2005 to 2017

Jacquet¹,

Pujol²,

Pauly³

et al. 2019

Orthopaedics & Traumatology: Surgery & Research

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Introduction: In 2008, the French National Authority for Health (HAS) recommended that "conservative" treatments be adopted for meniscal lesions. This recommendation and the lack of superiority of meniscectomy over non-operative treatment for meniscus degeneration have modified the treatment pathway. However, the impact of these findings on French clinical practice is not known. The objective of this study was to evaluate the change over time in the number of alternative surgical procedures (meniscectomy and meniscus repair) and regional variation in France using data from the French agency for information on hospital care (ATIH). Hypothesis: We hypothesized that the number of meniscectomy procedures will decrease, and the number of repair procedures will increase over time at various healthcare facilities. Patients and methods: Between 2005 and 2017, the number of hospitalizations in the Medicine-Surgery-Obstetrics wards for meniscectomy (NFFC003 and NFCC004) or meniscus repair (NFEC001 and NFEC002) was evaluated overall and then based on whether the stay occurred in public or private sector hospitals in France. Data were extracted from the ATIH database and the findings were (1) related to French demographics during the period in question; (2) separated into public or private sector hospitals; (3) distributed into various regions in France and; (4) stratified by patient age. Results: Between 2005 and 2017, 1,564,461 meniscectomy and 63,142 meniscus repair procedures were done in France. Over this period in the entire country, the meniscectomy rate gradually decreased from 19.80/10,000 inhabitants in 2005 to 15.77/10,000 inhabitants in 2017 (21.4% reduction) (p < 0.0001) while the meniscus repair rate increased from 0.42/10,000 inhabitants in 2005 to 1.36/10,000 inhabitants in 2017 (320% increase) (p < 0.0001). The largest meniscectomy reduction effort occurred in private sector hospitals, going from 15.79 to 12.01/10,000 inhabitants in 12 years; the decrease was smaller in public hospitals (going from 4.01 to 3.77/10,000 inhabitants) (p < 0.0001 in both cases). The change in the procedure ratio between private and public hospitals was asymmetric, with the meniscus repair/meniscectomy ratio clearly increasing more in public hospitals (4% to 12.6%) between 2005 and 2017 than in private hospitals (1.6% to 6.6%) (p < 0.0001). We found large regional differences: regions in Eastern France had higher meniscectomy rates, while regions in Western France had higher meniscus repair rates. When the analysis of procedures between 2008 and 2017 was stratified by age, a similar increase in repair procedures was found in all age brackets. Conversely, the reduction in meniscectomy was most apparent before 40 years of age, and the number of meniscectomy procedures was stable after 60 years of age. Conclusion: These findings suggest there has been a significant shift in the surgical management of meniscal injuries towards more conservative treatments. But the large variations between regions in France is evidence of a continued ...

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Section: Discussionmentioning

confidence: 99%

Analysis of the trends in arthroscopic meniscectomy and meniscus repair procedures in France from 2005 to 2017

Jacquet¹,

Pujol²,

Pauly³

et al. 2019

Orthopaedics & Traumatology: Surgery & Research

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“…The meniscus does have pain fibers. An extruded medial meniscus is associated with medial compartment pain and increased articular damage [16]. In the absence of mechanical symptoms, arthroscopic surgery is not useful [16].…”

Section: • Meniscusmentioning

confidence: 99%

“…An extruded medial meniscus is associated with medial compartment pain and increased articular damage [16]. In the absence of mechanical symptoms, arthroscopic surgery is not useful [16]. Increased vascularity and sensory nerve in-growth has been found in postmortem samples comparing OA with normal-appearing deceased individuals [17].…”

Section: • Meniscusmentioning

confidence: 99%

A Background for the Management of Osteoarthritic Knee Pain

Nelson

2014

Pain Manag.

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Knee osteoarthritis (KOA) is the most common degenerative arthritis and is treated by a wide range of practitioners. Treatment planning requires knowledge of the knee joint components and the influence of systemic and environmental factors. The treatment of KOA has changed little in 50 years. We are entering a new stage where KOA is now being viewed as an organ in failure. Neurotransmission of pain is both peripheral and central. Medical treatment can influence both pathways. Current guidelines for treatment have more rigid criteria based on the literature. In the future, the use of genetic-based biomarkers, clinical patterns of response and imaging characteristics will likely create subgroups of individuals who could benefit from improved designer therapies.

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Analyse de l’évolution des gestes de chirurgie méniscale arthroscopique (méniscectomie et suture) sur le territoire français entre 2005 et 2017 par l’utilisation de la masse de données du PMSI

Jacquet

Pujol

Pauly

et al. 2019

Revue de Chirurgie Orthopédique et Traumatologique

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Painful medial knee compartment syndrome in over-45 year-olds: I – Medical or surgical management: a series of 174 patients

Cited by 3 publications

References 18 publications

Analysis of the trends in arthroscopic meniscectomy and meniscus repair procedures in France from 2005 to 2017

Analysis of the trends in arthroscopic meniscectomy and meniscus repair procedures in France from 2005 to 2017

A Background for the Management of Osteoarthritic Knee Pain

Analyse de l’évolution des gestes de chirurgie méniscale arthroscopique (méniscectomie et suture) sur le territoire français entre 2005 et 2017 par l’utilisation de la masse de données du PMSI

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