Cost Analysis of Routine Examination of Pathology Specimens Following Ankle Arthroscopy

Trends of Ankle Arthroscopy in Italy: Analysis of an official National Database

OBJECTIVES

Ankle arthroscopy has become increasingly popular as a less invasive surgical diagnostic and therapeutic procedure for a variety ankle disorder previously managed with open surgery. Despite literature reports encouraging outcomes and low complication rates, nationwide trends in ankle arthroscopy have been poorly investigated. To fully understand the burden of an emerging surgical approach as well as helping to create global standards for the diagnosis and treatment of ankle diseases, this study aimed to evaluate the incidence and demographics of patients undergoing ankle arthroscopy in Italy from 2001 to 2016.

METHODS

Data were obtained from the National Hospital Discharge Records (SDO) provided by the Italian Ministry of Health. The patient's age, gender, length of hospital stays, primary diagnosis, and primary procedure are among the anonymized data. Population data were obtained from the National Institute for Statistics (ISTAT). According to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) ankle arthroscopy was defined by the following procedure code: 80.27.

RESULTS

A total of 23,644 procedures were performed in Italy. The 25-29 and 30-34 age groups underwent this type of surgery at most. The majority of patients were males. The median length of hospital stay was 2.1 ± 2.3 days. Each year in Italy, this surgery costs an average of 2,133,401€ ± 342,143€. The main primary codified diagnoses were: "Contracture of joint, ankle and foot" (13.4%), "Articular cartilage disorder, ankle and foot" (8.6%), "Late effect of sprain and strain without mention of tendon injury" (7.5%) and "Other joint derangement, not elsewhere classified, ankle and foot" (6.4%).

CONCLUSIONS

The present study evaluated the burden of ankle arthroscopy on the national health care system and the distribution of the main diseases requiring this type of surgery. Surgeons and policy makers can allocate healthcare resources more effectively and provide patients with high-quality care by having a better understanding of national practice patterns.

LEVEL OF EVIDENCE

III.

Non-neoplastic bone, joint, and soft tissue pathology: What every pathologist should know

The diagnosis of bone and soft tissue tumors is a skill which requires experience across multiple disciplines while their incidence is small. By contrast, the numbers of patients with non-tumorous diseases of bones, soft tissues, and joints dwarfs primary tumors by several orders of magnitude. The ability to successfully diagnose non-neoplastic diseases requires a knowledge of bone development, structure, remodeling, imaging, and tissue processing. This review summarizes the alterations of bones, joints, and to a lesser extent soft tissues that are encountered in the practice of everyday surgical pathology.