Abstract
BACKGROUND: In situations of osteoarthritis (OA), the therapeutic value of knee arthroscopy is still a topic of discussion that is ongoing. This study aims to produce data about the relevance of arthroscopy and total knee arthroplasty (TKA) in knee OA by assessing the overall rates of arthroscopy and subsequent conversion to TKA over a two-year period in QLD Australia within the time frame between 2008 and 2023. METHODS: A retrospective cohort analysis was undertaken at Queensland (QLD) hospitals that underwent arthroscopy and TKA between 2008 and 2023. Research datasets obtained from the Centre for Health Record Linkage (CHeReL) were analyzed using negative binomial regression. An investigation was performed to determine the rates of arthroscopy admissions by year, age group, sex, and hospital system (public versus private). The TKA readmission rates were calculated during a 24-month period. RESULTS: The results demonstrate an overall decrease in the frequency of arthroscopies from 2008 to 2022, but total knee arthroplasties (TKA) have increased by 2.79% (95% CI: 2.19 to 3.38). There was a 3.34% reduction in arthroscopy rates at private hospitals and a 0.98% drop at public hospitals (95% CI: -0.26 to 2.23). The largest significant rise in TKA rates was seen in private hospitals. The TKA procedure was performed on 14.48% of patients aged 65 and older within 24 months of knee arthroscopy. After taking sex and age into account, there was a 4.97% reduction in the occurrence of total knee TKA within 24 months following knee arthroscopy (95% CI: -5.55 to -4.40) across the board. CONCLUSIONS: While the rates of TKA are on the rise, arthroscopies and their conversions to TKA are on the decrease. Possible explanations for the persistent drop in TKA conversion rates include better patient selection, more effective non-operative care, or longer wait times for the operation.