title: Changes in rates of arthroscopy due to degenerative knee disease and traumatic meniscal tears in Finland and Sweden.
abstract: OBJECTIVE
  Knee arthroscopy is commonly performed to treat degenerative knee disease symptoms and traumatic meniscal tears. We evaluated whether the recent high-quality randomized control trials not favoring arthroscopic surgery for degenerative knee disease affected the procedure incidence and trends in Finland and Sweden.
  
  
  METHODS
  We conducted a bi-national registry-based study including all adult (aged ≥18 years) inpatient and outpatient arthroscopic surgeries performed for degenerative knee disease (osteoarthritis (OA) and degenerative meniscal tears) and traumatic meniscal tears in Finland between 1997 and 2012, and in Sweden between 2001 and 2012.
  
  
  RESULTS
  In Finland, the annual number of operations was 16,389 in 1997, reached 20,432 in 2007, and declined to 15,018 in 2012. In Sweden, the number of operations was 9,944 in 2001, reached 11,711 in 2008, and declined to 8,114 in 2012. The knee arthroscopy incidence for OA was 124 per 10(5) person-years in 2012 in Finland and it was 51 in Sweden. The incidence of knee arthroscopies for meniscal tears coded as traumatic steadily increased in Finland from 64 per 10(5) person-years in 1997 to 97 per 10(5) person-years in 2012, but not in Sweden.
  
  
  CONCLUSIONS
  The incidence of arthroscopies for degenerative knee disease declined after 2008 in both countries. Remarkably, the incidence of arthroscopy for degenerative knee disease and traumatic meniscal tears is 2 to 4 times higher in Finland than in Sweden. Efficient implementation of new high-quality evidence in clinical practice could reduce the number of ineffective surgeries.
authors.affiliation: a 1 Division of Orthopedics and Traumatology, Department of Trauma, Musculoskeletal Surgery and Rehabilitation, Tampere University Hospital , Tampere, Finland.|b 2 Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Division of Orthopedics and Biotechnology, Karolinska Institutet and Department of Orthopedics at Karolinska University Hospital Huddinge , Stockholm, Sweden.
authors.forename: Ville M
authors.initials: VM
authors.lastname: Mattila
authors.affiliation: c 3 Department of Orthopedics, Hatanpää Hospital , Tampere.
authors.forename: Raine
authors.initials: R
authors.lastname: Sihvonen
authors.affiliation: d 4 Department of Surgery , Central Finland Hospital, Jyväskylä, Finland.
authors.forename: Juha
authors.initials: J
authors.lastname: Paloneva
authors.affiliation: b 2 Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Division of Orthopedics and Biotechnology, Karolinska Institutet and Department of Orthopedics at Karolinska University Hospital Huddinge , Stockholm, Sweden.
authors.forename: Li
authors.initials: L
authors.lastname: Felländer-Tsai
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001182:Arthroscopy / Q000379:methods / Q000706:statistics & numerical data*; D016001:Confidence Intervals; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D007718:Knee Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D012042:Registries; D012720:Severity of Illness Index; D017678:Sex Distribution; D013548:Sweden / Q000453:epidemiology; D000070600:Tibial Meniscus Injuries; D016896:Treatment Outcome; D055815:Young Adult