Increased rates of knee arthroplasty and cost of patients with meniscal tears treated with arthroscopic partial meniscectomy versus non-operative management

  • Brandon BarndsEmail author
  • Brandon Morris
  • Scott Mullen
  • John Paul Schroeppel
  • Armin Tarakemeh
  • Bryan G. Vopat



The purpose of this study was to determine the cost of arthroscopic partial meniscectomy (APM), one of the most common surgeries performed by orthopaedic surgeons, and the associated rate of progression to knee arthroplasty (KA) compared to patients treated non-operatively after diagnosis of meniscal tear.


Utilizing data mining software (PearlDiver, Colorado Springs, CO), a national insurance database of approximately 23.5 million orthopaedic patients was queried for patients diagnosed with a meniscal tear. Patients were classified by treatment: non-operative and arthroscopic partial meniscectomy and were followed after initial diagnosis for cost and progression to knee arthroplasty.


There were 176,407 subjects in the non-op group and 114,194 subjects in the arthroscopic partial meniscectomy group. Arthroscopic partial meniscectomy generated more cost than non-operative ($3842.57 versus $411.05, P < 0.001). Arthroscopic partial meniscectomy demonstrated greater propensity to need future knee arthroplasty (11.4% at 676 days) than those treated non-operatively (9.5% at 402 days) (P < 0.001). Female patients demonstrated a higher rate of progression to knee arthroplasty in the arthroscopic partial meniscectomy and non-operative groups (P < 0.001).


Compared to non-operative treatment for meniscal tears, arthroscopic partial meniscectomy is more expensive and does not appear to decrease the rate of progression to knee arthroplasty. Patients undergoing arthroscopic partial meniscectomy yielded on average a delay of only 9 months (274 days) before undergoing knee arthroplasty. Female patients experienced a significantly higher rate of progression to knee arthroplasty. The authors recognize the limitations of this type of study including its retrospective nature, reliance upon accurate coding and billing information, and the inability to determine whether symptoms including mechanical locking played a role in the decision to perform an APM.

Level of evidence



Meniscal tear Meniscectomy Knee arthroscopy Knee Total knee replacement Total knee arthroplasty 



Knee osteoarthritis


Body mass index


Physical therapy


Arthroscopic partial meniscectomies


International classification of diseases


Current procedural terminology


Total knee arthroplasties


Knee arthroplasty


Randomized controlled trial


Author contributions

BB: primary author and orthopaedic resident responsible for all aspects of study and manuscript. BM: co-author and orthopaedic resident responsible for background, study design, analysis, and review. AT: co-author and orthopaedic research assistant responsible for database management, analysis, and review. JPS: co-author and orthopaedic attending responsible for background, study design, analysis, and review. SM: co-author and orthopaedic attending responsible for background, study design, analysis, and review. BV: primary investigator and orthopaedic attending responsible for background, study design, analysis, and review.


Funding was provided by the Department of Orthopedics at The University of Kansas Medical Center, no outside funding was used.

Compliance with ethical standards

Conflict of interest

None of the authors have any relevant conflicts of interest pertaining to this research.

Ethical approval

This study was approved by the Institutional Review Board at The University of Kansas Medical Center.

Supplementary material

167_2019_5481_MOESM1_ESM.docx (25 kb)
Supplementary material 1 (DOCX 25 KB)
167_2019_5481_MOESM2_ESM.tif (23 kb)
Supplemental Figure 1: Kaplan-Meier survival analysis illustrating the ratio of patients within each treatment group that did not require KA, and the number of days since initial diagnosis of meniscal tear to KA. (TIF 23 KB)


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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019

Authors and Affiliations

  1. 1.Department of OrthopaedicsThe University of Kansas Medical CenterKansas CityUSA

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