title: Total Knee Arthroplasty After Knee Arthroscopy in Patients Older Than 50 Years.
abstract: Several orthopedic registries have described the incidence of total knee arthroplasty (TKA) in patients who have undergone knee arthroscopy. Patient risk factors may play a role in the conversion rate from knee arthroscopy to TKA. This study quantifies the incidence of conversion of knee arthroscopy to TKA from a US mixed-payer database and describes some common patient risk factors for conversion. The medical records of more than 50 million patients who were treated between 1998 and 2014 were mined with a commercially available software platform. During the study period, a total of 68,090 patients older than 50 years underwent knee arthroscopy for partial meniscectomy, chondroplasty, or debridement. Reported rates of TKA at 1, 2, and 3 years after arthroscopy were 10.1%, 13.7%, and 15.6%, respectively. Obesity, depressive disorder, rheumatoid arthritis, diabetes, and age 70 years and older were associated with increased relative risk of conversion to TKA at 2 years. When obesity was combined individually with the top 5 other risk factors, no combination produced a higher relative risk than that of obesity alone. Patients who were 50 to 54 years of age had the lowest incidence of conversion to TKA (8.3%, P<.001). Men had a lower incidence of conversion to TKA (11.3%) than women (15.8%, P<.001). This information can help surgeons to counsel patients on the incidence of TKA after knee arthroscopy and identify preoperative risk factors that increase risk. [Orthopedics. 2016; 39(6):e1041-e1044.].
authors.forename: Jason A
authors.initials: JA
authors.lastname: Boyd
authors.forename: Ian M
authors.initials: IM
authors.lastname: Gradisar
mesh_terms: D000367:Age Factors; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications; D019645:Arthroplasty, Replacement, Knee / Q000706:statistics & numerical data*; D001182:Arthroscopy / Q000706:statistics & numerical data*; D002358:Cartilage, Articular / Q000601:surgery; D016208:Databases, Factual; D003646:Debridement; D003866:Depressive Disorder / Q000150:complications; D048909:Diabetes Complications / Q000150:complications; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D012086:Reoperation / Q000706:statistics & numerical data*; D012307:Risk Factors; D012737:Sex Factors