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Long-term National Trends of Arthroscopic Meniscal Repair and Debridement.

Publication ,  Journal Article
Wasserburger, JN; Shultz, CL; Hankins, DA; Korcek, L; Martin, DF; Amendola, A; Richter, DL; Schenck, RC; Treme, GP
Published in: Am J Sports Med
May 2021

BACKGROUND: Optimal treatment of meniscal pathology continues to evolve in orthopaedic surgery, with a growing understanding of which patients benefit from which procedure and which patients might be best treated nonsurgically. In 2002, Moseley et al found no difference between arthroscopic procedures, including meniscal debridement and sham surgery, in patients with osteoarthritis of the knee. This called into question the role of routine arthroscopic debridement in these patients. Additionally, an increased interest in understanding and maintaining the function of the meniscus has more recently resulted in a greater focus on meniscal preservation procedures. STUDY DESIGN: Descriptive epidemiology study. PURPOSE/HYPOTHESIS: The purpose was to evaluate the trends of arthroscopic meniscal debridement and repair and the characteristics of the patients receiving these treatments, compare the differences in practice between newly trained orthopaedic sports medicine specialists and those of other specialties, and analyze if there are differences in practice by region. It was hypothesized that the American Board of Orthopaedic Surgery (ABOS) database would evaluate practice patterns of recent graduates as a surrogate for current treatment and training and, consequently, demonstrate a decreased rate of meniscal debridement. METHODS: Data from ABOS Part II examinees from 2001 to 2017 were obtained from the ABOS Case List. Current Procedure Terminology (CPT) codes related to arthroscopic meniscal treatment were selected. The examination year, age of the patient, practice region, and examinee subspecialty were analyzed. Patient age was stratified into 4 groups: <30, 30 to 50, 51 to 65, and >65 years. Examinee subspecialty was stratified into sports medicine and non-sports medicine. Statistical regression analysis was performed. RESULTS: Between 2001 and 2017, ABOS Part II examinees submitted 131,047 cases with CPT codes 29880 to 29883. Meniscal debridement volume decreased for all age groups during the study period, while repair increased. Sports medicine subspecialists were more likely than their counterparts to perform repair over debridement in patients aged younger than 30 years (P = .0004) and between 30 and 50 years (P = .0005). CONCLUSION: This study provides insights into arthroscopic meniscal debridement and repair practice trends among ABOS Part II examinees. Meniscal debridement is decreasing and meniscal repair is increasing. Younger patient age and treatment by a sports medicine subspecialty examinee are associated with a higher likelihood of repair over debridement.

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Published In

Am J Sports Med

DOI

EISSN

1552-3365

Publication Date

May 2021

Volume

49

Issue

6

Start / End Page

1530 / 1537

Location

United States

Related Subject Headings

  • Sports Medicine
  • Orthopedics
  • Orthopedics
  • Meniscus
  • Humans
  • Debridement
  • Arthroscopy
  • Aged
  • 4207 Sports science and exercise
  • 4201 Allied health and rehabilitation science
 

Citation

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Wasserburger, J. N., Shultz, C. L., Hankins, D. A., Korcek, L., Martin, D. F., Amendola, A., … Treme, G. P. (2021). Long-term National Trends of Arthroscopic Meniscal Repair and Debridement. Am J Sports Med, 49(6), 1530–1537. https://doi.org/10.1177/0363546521999419
Wasserburger, Jory N., Christopher L. Shultz, David A. Hankins, Lucas Korcek, David F. Martin, Annunziato Amendola, Dustin L. Richter, Robert C. Schenck, and Gehron P. Treme. “Long-term National Trends of Arthroscopic Meniscal Repair and Debridement.Am J Sports Med 49, no. 6 (May 2021): 1530–37. https://doi.org/10.1177/0363546521999419.
Wasserburger JN, Shultz CL, Hankins DA, Korcek L, Martin DF, Amendola A, et al. Long-term National Trends of Arthroscopic Meniscal Repair and Debridement. Am J Sports Med. 2021 May;49(6):1530–7.
Wasserburger, Jory N., et al. “Long-term National Trends of Arthroscopic Meniscal Repair and Debridement.Am J Sports Med, vol. 49, no. 6, May 2021, pp. 1530–37. Pubmed, doi:10.1177/0363546521999419.
Wasserburger JN, Shultz CL, Hankins DA, Korcek L, Martin DF, Amendola A, Richter DL, Schenck RC, Treme GP. Long-term National Trends of Arthroscopic Meniscal Repair and Debridement. Am J Sports Med. 2021 May;49(6):1530–1537.
Journal cover image

Published In

Am J Sports Med

DOI

EISSN

1552-3365

Publication Date

May 2021

Volume

49

Issue

6

Start / End Page

1530 / 1537

Location

United States

Related Subject Headings

  • Sports Medicine
  • Orthopedics
  • Orthopedics
  • Meniscus
  • Humans
  • Debridement
  • Arthroscopy
  • Aged
  • 4207 Sports science and exercise
  • 4201 Allied health and rehabilitation science