title: Incidence of knee cartilage surgery in Norway, 2008-2011.
abstract: OBJECTIVE
  A systematic and long-term data collection on the treatment of focal cartilage defects (FCDs) of the knee is needed. This can be achieved through the foundation of a National Knee Cartilage Defect Registry. The aim of this study was to establish the nationwide burden of knee cartilage surgery, defined as knee surgery in patients with an FCD. We also aimed to identify any geographical differences in incidence rates, patient demographics or trends within this type of surgery.
  
  
  METHODS
  A population-based study with retrospective identification of patients undergoing knee cartilage surgery in Norway through a mandatory public health database from 2008 to 2011.
  
  
  METHODS
  We identified all patients undergoing cartilage surgery, or other knee surgery in patients with an FCD. All eligible surgeries were assessed for inclusion on the basis of certain types of ICD-10 and NOMESKO Classification of Surgical Procedures codes.
  
  
  METHODS
  The variables were diagnostic and surgical codes, geographic location of the performing hospital, age and sex of the patients. Yearly incidence and incidence rates were calculated. Age-adjusted incidences for risk ratios and ORs between geographical areas were also calculated.
  
  
  RESULTS
  A total of 10,830 cases of knee cartilage surgery were identified, with slight but significant decreases from 2008 to 2011 (p<0.0003). The national incidence rate was 56/100 000 inhabitants and varied between regions, counties and hospitals. More than 50% of the procedures were palliative and nearly 400 yearly procedures were reparative or restorative.
  
  
  CONCLUSIONS
  Knee cartilage surgery is common in Norway, counting 2500 annual cases with an age-adjusted incidence rate of 68.8/100,000 inhabitants. There are significant geographical variations in incidence and trends of surgery and in trends between public and private hospitals. We suggest that a national surveillance system would be beneficial for the future evaluation of the treatment of these patients.
authors.affiliation: Oslo Sports Trauma Research Center (OSTRC), Norwegian School of Sports Sciences, Oslo, Norway Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Cathrine Nørstad
authors.initials: CN
authors.lastname: Engen
authors.affiliation: Oslo Sports Trauma Research Center (OSTRC), Norwegian School of Sports Sciences, Oslo, Norway Department of Orthopedic Surgery, Akershus University Hospital, Lørenskog, Norway Institute of Clinical Medicine, University of Oslo, Lørenskog, Norway.
authors.forename: Asbjørn
authors.initials: A
authors.lastname: Årøen
authors.affiliation: Oslo Sports Trauma Research Center (OSTRC), Norwegian School of Sports Sciences, Oslo, Norway Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway Department of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway.
authors.forename: Lars
authors.initials: L
authors.lastname: Engebretsen
mesh_terms: D000328:Adult; D000368:Aged; D002357:Cartilage Diseases / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D038801:International Classification of Diseases; D007717:Knee / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D019637:Orthopedic Procedures / Q000706:statistics & numerical data* / Q000639:trends; D012042:Registries; D012189:Retrospective Studies
keywords: EPIDEMIOLOGY