Incidence of Total Knee Arthroplasty After Arthroscopic Surgery for Knee Osteoarthritis: A Secondary Analysis of a Randomized Clinical Trial
Primary result · TKAResult — go to the resultAdjusted hazard ratio 0.85 95% CI 0.52–1.40Authors' conclusion
In this secondary analysis of a randomized clinical trial of arthroscopic surgery for patients with OA of the knee, a statistically significant association with delaying or hastening TKA was not identified.
Study context
- Population
- Adults with knee osteoarthritis (OA) referred for potential arthroscopic surgery, tertiary orthopaedic centre, London, Ontario, Canadaof 277 eligible
- Participants
- 178 adults
- Comparison
- Arthroscopic surgery plus nonoperative management vs nonoperative management only
- Arthroscopic surgeryn = 92
- Controln = 86reference
- Primary endpoint
- Incidence of total knee arthroplasty (TKA) (follow-up up to 20 years)
Methodological detailsad hoc secondary analysis, single-centre, assessor-blinded, linkage to Canadian health administrative datasets, multivariable Cox proportional hazards regression, Trial performed January 1, 1999, to August 31, 2007; follow-up through March 31, 2019
- Ad hoc secondary analysis
- Single-centre
- Assessor-blinded
- Linkage to Canadian health administrative datasets
- Multivariable Cox proportional hazards regression
- Trial performed January 1, 1999, to August 31, 2007; follow-up through March 31, 2019
Primary result
TKA · median follow-up 13.8 (IQR, 8.4-16.8) years
Adjusted hazard ratio
0.85
95% CI 0.52–1.40
Events by treatment group
Arthroscopic surgeryvs Control
aHR 0.85 (95% CI 0.52–1.40)
As reported in the abstract
Further findings
| Outcome | Arthroscopic surgery | Control | Estimate | |
|---|---|---|---|---|
| TKA accounting for crossovers to arthroscopic surgery (13 of 86 [15.1%]) | HR 0.88 (95% CI 0.53–1.44) | |||
| Cumulative incidence of TKA within 5 years | 10.2% | 9.3% | time-stratified HR for 0-5 years 1.06 (95% CI 0.41–2.75) | |
| Cumulative incidence of TKA within 10 years | 23.3% | 21.4% | time-stratified HR for 5-10 years 1.06 (95% CI 0.45–2.51) | |
| 0.20.5125Ratio (log scale) |
Sensitivity analyses
- Sensitivity analyses yielded consistent results
Original publication
Incidence of Total Knee Arthroplasty After Arthroscopic Surgery for Knee Osteoarthritis: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. Published 1 April 2024. doi:10.
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