Knie-artrose

Fietsen verstandig?

Feit

Bij hardlopen wordt de knie belast met 6x uw lichaamsgewicht bij elke stap

Máxima Medisch Centrum

Value-Based Health Care

ESSKA Accredited Teacher

Orthopedie Groot Eindhoven

Goede uitleg is essentieel voor juiste keuze behandeling

Meniscus-scheur

Voorste kruisbandreconstructie

Achterste kruisbandletsel

Zorg op maat

YouTube kanaal dr RPA Janssen

Internationaal wetenschappelijk onderzoek

Kruisbandoperaties knie

RPA Janssen MD PhD

Kruisbandoperaties

Waardegedreven zorg

Last van knie-artrose?

Spreekuur / Policlinique / Outpatient clinic

Nederlandse Vereniging voor Arthroscopie

Máxima Medisch Centrum

Kruisbandoperaties bij kinderen

Veel pijn bij ernstige knie-artrose?

Samen met uw arts gekozen voor een knie-operatie?

Eenzijdige knie-artrose knie en actief leven?

Máxima Medisch Centrum Eindhoven-Veldhoven

Kwaliteit van leven

Samen kiezen voor de beste behandeling

Sporten met plezier

Oplossingen voor de lange termijn

Associate Professor Knee Reconstruction

Fact

Kneecap pain is a regular occurrence in fitness knee rehabilitation

Knee osteoarthritis

Cycling wise?

Fact

When running, the knee is loaded with 6x your body weight with each step

In Gesprek Met de Opleider

Dr. RPA Janssen is uitgenodigd voor een...

RPA Janssen
9e Nationaal Coassistenten Congre, March 8-10, 2024. Egmond aan Zee, The Netherlands
Lees meer

Performing a knee arthroscopy among patients with degenerative knee disease: one-third is potentially low value care

Rietbergen T, Maren-van de Mheen PJ, Diercks RL, Janssen RPA, van der Linder-van der Zwaag HMJ, Nelissen RGHH, Steyerberg EW, van Bodegom-Vos L, for the SMART study group
Knee Surg, Sports Traumatology, Arthroscopy Online June 19, 2021

Abstract

Purpose The purpose of this study was to assess in which proportion of patients with degenerative knee disease aged 50+ in whom a knee arthroscopy is performed, no valid surgical indication is reported in medical records, and to explore pos- sible explanatory factors.

Methods A retrospective study was conducted using administrative data from January to December 2016 in 13 orthopedic centers in the Netherlands. Medical records were selected from a random sample of 538 patients aged 50+ with degenerative knee disease in whom arthroscopy was performed, and reviewed on reported indications for the performed knee arthroscopy. Valid surgical indications were predefined based on clinical national guidelines and expert opinion (e.g., truly locked knee). A knee arthroscopy without a reported valid indication was considered potentially low value care. Multivariate logistic regression analysis was performed to assess whether age, diagnosis (“Arthrosis” versus “Meniscal lesion”), and type of care trajectory (initial or follow-up) were associated with performing a potentially low value knee arthroscopy.

Results Of 26,991 patients with degenerative knee disease, 2556 (9.5%) underwent an arthroscopy in one of the partici- pating orthopedic centers. Of 538 patients in whom an arthroscopy was performed, 65.1% had a valid indication reported in the medical record and 34.9% without a reported valid indication. From the patients without a valid indication, a joint patient–provider decision or patient request was reported as the main reason. Neither age [OR 1.013 (95% CI 0.984–1.043)], diagnosis [OR 0.998 (95% CI 0.886–1.124)] or type of care trajectory [OR 0.989 (95% CI 0.948–1.032)] were significantly associated with performing a potentially low value knee arthroscopy.

Conclusions In a random sample of knee arthroscopies performed in 13 orthopedic centers in 2016, 65% had valid indica- tions reported in the medical records but 35% were performed without a reported valid indication and, therefore, potentially low value care. Patient and/or surgeons preference may play a large role in the decision to perform an arthroscopy without a valid indication. Therefore, interventions should be developed to increase adherence to clinical guidelines by surgeons that target invalid indications for a knee arthroscopy to improve care.