Incidence of knee arthroscopy in patients over 60 years of age in Scotland.

Arthroscopy has been utilised in the management of knee osteoarthritis for over 70 years but in recent years there has been growing debate about the efficacy of such treatment. We reviewed data from a national register, the Scottish Arthroplasty Project. We analysed 8897 knee arthroscopies performed in patients aged over 60 in Scotland between 1997 and 2006. Marked regional differences were noted for the rate of arthroscopy, with an upper rate of 230 arthroscopies per 100,000 age corrected population and a low of 80 per 100,000. No apparent reasons could be identified for this disparity. Regions with the highest rate of arthroscopy also had the highest rate of conversion to knee arthroplasty within 2 years, indicating a high level of ineffective and inappropriate arthroscopic surgery being performed in many areas of Scotland.