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Rates of knee arthroplasty in patients with a history of arthroscopic chondroplasty: results from a retrospective cohort study utilising the National Hospital Episode Statistics for England

Research output: Contribution to journalArticle

Original languageEnglish
JournalBMJ Open
DateAccepted/In press - 13 Jan 2020

Abstract

OBJECTIVE
The purpose of this study was to analyse the rate of knee arthroplasty in the population of patients with a history of arthroscopic chondroplasty of the knee, in England, over ten years, with comparison to general population data for patients without a history of chondroplasty.

DESIGN
Retrospective cohort study.

SETTING
English hospital episode statistics (HES) data.

PARTICIPANTS AND INTERVENTIONS
Patients undergoing arthroscopic chondroplasty in England between 2007/08 and 2016/17 were identified. Patients undergoing previous arthroscopic knee surgery or simultaneous cruciate ligament reconstruction or microfracture in the same knee were excluded.

OUTCOMES
Patients subsequently undergoing a knee arthroplasty in the same knee were identified and mortalityadjusted survival analysis was performed (survival without undergoing knee arthroplasty). A Cox proportional hazards model was used to identify factors associated with knee arthroplasty. Relative risk of knee arthroplasty (total or partial) in comparison to the general population was determined.

RESULTS
Through 2007-17, 157,730 eligible chondroplasty patients were identified. Within one-year, 5.91% (7984/135197; 95% CI 5.78 to 6.03) underwent knee arthroplasty and 14.22% (8145/57267; 95% CI 13.94 to 14.51) within five-years. Patients aged over 30 years with a history of chondroplasty were 17.32 times (risk ratio; 95% CI 16.81 to 17.84) more likely to undergo arthroplasty than the general population without a history of chondroplasty.

CONCLUSIONS
Patients with cartilage lesions of the knee, treated with arthroscopic chondroplasty, are at greater risk of subsequent knee arthroplasty than the general population and for a proportion of patients, there is insufficient benefit to prevent the need for knee arthroplasty within one- to five-years. These important new data will inform patients of the anticipated outcomes following this procedure. The risk in comparison to non-operative treatment remains unknown and there is an urgent need for a randomised clinical trial in this
population.

    Research areas

  • knee, arthroscopy, chondroplasty, knee replacement, arthroplasty, outcomes, osteoarthritis

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  • Full-text PDF (author’s accepted manuscript)

    Accepted author manuscript, 4.65 MB, PDF document

    Embargo ends: 1/01/99

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