Number of Knee Arthroscopic Procedures Declines

MedicalResearch.com Interview with:


Dr. Howard

Prof. David H. Howard PhD
Department of Health Policy and Management
Emory University
Atlanta, GA 30322

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: There is a lot of skepticism that physicians respond to evidence, especially when trials report that widely-used, separately-reimbursed procedures are not effective.

Physicians are reluctant to abandon treatments. This study shows that in the case of knee arthroscopy, evidence has made a difference. The use of knee arthroscopy declined by 23% in Florida between 2002 and 2015. This change occurred despite increases in the prevalence of osteoarthritis. 

MedicalResearch.com: What should readers take away from your report?

Response: Trials of established procedures are worthwhile. They can influence how doctors treat patients. In the case of knee arthroscopy, evidence may have had more of an impact because there were multiple trials that all reached the same conclusion.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Knee arthroscopy has declined, but it is unclear if it is still overused. It would be interesting to know how treatment patterns vary between orthopedic surgeons in private practice versus those who are employed by hospitals and health systems. Also, what are the underlying changes in care that have contributed to the decline? Are patients less likely to pursue surgery? Are physicians counseling against immediate surgery

MedicalResearch.com: Is there anything else you would like to add?

Response: Many experts think physicians are slow to respond to evidence, but beliefs about the impact of evidence are not always evidenced-based. I have no disclosures/conflicts.


Howard DH. Trends in the Use of Knee Arthroscopy in Adults. JAMA Intern Med. Published online September 24, 2018. doi:10.1001/jamainternmed.2018.4175

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Last Updated on September 25, 2018 by Marie Benz MD FAAD