title: Meniscus surgery is still widely performed in the treatment of degenerative meniscus tears in The Netherlands.
abstract: OBJECTIVE
  Studies have demonstrated rising incidences of meniscus procedures for degenerative meniscus tears in several countries, despite accumulating evidence that questions the efficacy of the treatment. It is not clear if this rise in incidences also applies to the practice of arthroscopic surgery in the Netherlands. The objective of this study was, therefore, to evaluate the number of meniscal surgeries performed in the Netherlands between 2005 and 2014.
  
  
  METHODS
  We used registry-based data on meniscal surgeries that originated from Dutch national hospital basic care registrations from 2005 to 2014. Poisson regression models were used to test differences in incidences of meniscus surgeries performed in the Netherlands between 2005 and 2014, and to find out if changes in incidences over this period differed for younger and older patients.
  
  
  RESULTS
  The number of meniscus surgeries was highest in patients aged 40-65 years, who accounted for half of the total number of meniscal surgeries. The incidences of meniscus surgeries decreased from 2005 to 2014 (p < 0.001); this decrease was observed in all age groups, although the decrease in incidences was more pronounced for younger patients (aged less than 40 years) compared to middle-aged and older patients (aged 40 years and older) (p < 0.001).
  
  
  CONCLUSIONS
  The implementation of a nationwide guideline for arthroscopic procedures for meniscus tears may have contributed to a decrease in incidences of meniscus procedures. Despite accumulating evidence that questions the rationalisation and effectiveness of the treatment, meniscus surgery is still widely performed in the treatment of degenerative meniscus tears in the Netherlands, demonstrating a delay in the dissemination, acceptance, and implementation of clinical evidence in the practice of arthroscopic surgery in the Netherlands.
  
  
  METHODS
  II.
authors.affiliation: Department of operating rooms, Radboud University Medical Center, Radboud Institute for Health Sciences, PO Box 9101, 6500 HB, Nijmegen, The Netherlands. Jan.Rongen@radboudumc.nl.
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Rongen
authors.affiliation: Kliniek Viasana, Mill, The Netherlands.
authors.forename: Tony G
authors.initials: TG
authors.lastname: van Tienen
authors.affiliation: Orthopaedic Research Laboratory, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
authors.forename: Pieter
authors.initials: P
authors.lastname: Buma
authors.affiliation: Orthopaedic Research Laboratory, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
authors.forename: Gerjon
authors.initials: G
authors.lastname: Hannink
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy / Q000706:statistics & numerical data* / Q000639:trends; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D000074403:Meniscectomy / Q000706:statistics & numerical data* / Q000639:trends; D008875:Middle Aged; D009426:Netherlands; D010818:Practice Patterns, Physicians' / Q000639:trends*; D012042:Registries; D000070600:Tibial Meniscus Injuries / Q000601:surgery*; D055815:Young Adult
keywords: Guidelines; Incidences; Meniscal; Meniscectomy; Meniscus: arthroscopy; Registry