Dataset Information

Office-Based Needle Arthroscopy: A Standardized Diagnostic Approach to the Knee.

ABSTRACT: Surgical knee arthroscopy is among the most commonly performed procedures in the United States. The decision to treat is often based on clinical examination and magnetic resonance imaging. Equivocal results frequently require patients to undergo surgical arthroscopy, exposing the patient to inherent risks and potential surgical complications. Office-based needle arthroscopy provides an alternative approach to visualizing intra-articular anatomy and pathology in real time. The purpose of this article is to provide a standardized diagnostic approach to needle arthroscopy of the knee.

SUBMITTER: McMillan S

PROVIDER: S-EPMC5621831 | biostudies-other | 2017 Aug

REPOSITORIES: biostudies-other

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Office-Based Needle Arthroscopy: A Standardized Diagnostic Approach to the Knee.

McMillan Sean S Saini Sundeep S Alyea Eric E Ford Elizabeth E

Arthroscopy techniques 20170724 4

Surgical knee arthroscopy is among the most commonly performed procedures in the United States. The decision to treat is often based on clinical examination and magnetic resonance imaging. Equivocal results frequently require patients to undergo surgical arthroscopy, exposing the patient to inherent risks and potential surgical complications. Office-based needle arthroscopy provides an alternative approach to visualizing intra-articular anatomy and pathology in real time. The purpose of this art ...[more]

PMID: 29354406

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Project description:BackgroundHundreds of thousands of surgical arthroscopy procedures are performed annually in the United States (US) based on MRI findings. There are situations where these MRI findings are equivocal or indeterminate and because of this clinicians commonly perform the arthroscopy in order not to miss pathology. Recently, a less invasive needle arthroscopy system has been introduced that is commonly performed in the physician office setting and that may help improve the accuracy of diagnostic findings. This in turn may prevent unnecessary follow-on arthroscopy procedures from being performed.ObjectiveThe purpose of this analysis is to determine whether the in-office diagnostic needle arthroscopy system can provide cost savings by reducing unnecessary follow on arthroscopy procedures.MethodsData obtained from a recent trial and from a systematic review were used in comparing the accuracy of MRI and VisionScope needle arthroscopy (VSI) with standard arthroscopy (gold standard). The resultant false positive and false negative findings were then used to evaluate the costs of follow-on procedures. These differences were then modeled for the US patient population diagnosed and treated for meniscal knee pathology (most common disorder) to determine if a technology such as VSI could save the US healthcare system money. Data on surgical arthroscopy procedures in the US for meniscal knee pathology were used (calendar year [CY] 2010). The costs of performing diagnostic and surgical arthroscopy procedures (using CY 2013 Medicare reimbursement amounts), costs associated with false negative findings, and the costs for treating associated complications arising from diagnostic and therapeutic arthroscopy procedures were assessed.ResultsIn patients presenting with medial meniscal pathology (International Classification of Diseases, 9th edition, Clinical Modification [ICD9CM] diagnosis 836.0), VSI in place of MRI (standard of care) resulted in a net cost savings to the US system of US$115-US$177 million (CY 2013) (use of systematic review and study data, respectively). In patients presenting with lateral meniscus pathology (ICD9CM 836.1), VSI in place of MRI cost the healthcare system an additional US$14-US$97 million (CY 2013). Overall aggregate savings for meniscal (lateral plus medial) pathology were identified in representative care models along with more appropriate care as fewer patients were exposed to higher risk surgical procedures.ConclusionsSince in-office arthroscopy is significantly more accurate, patients can be treated more appropriately and the US healthcare system can save money, most especially in medial meniscal pathology.

Dataset Information

Office-Based Needle Arthroscopy: A Standardized Diagnostic Approach to the Knee.

Publications

Office-Based Needle Arthroscopy: A Standardized Diagnostic Approach to the Knee.

Similar Datasets

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