Peripheral nerve injuries leading to paralysis are not uncommon. Unfortunately, they are often approached with fatalism, most of us expecting a slow and often incomplete recovery as we are not familiar with the possibilities offered by nerve transfers. Being aware of the possibility of nerve transfers and the importance of not delaying referral enables patients to be directed to specialized teams and opens up new perspectives in terms of functional recovery.
On the other hand, the rate of meniscectomy beyond the age of 50 has been an indicator of clear deviation from good medical practice for the INAMI since April 2023, as meniscectomy beyond a certain age is considered to precipitate arthritis and the need for arthroplasty. The establishment of this indicator may lead to perverse behavior by increasing the number of patients operated on under the age of 50. Knee osteoarthritis is not directly correlated with age, and many factors need to be considered. We propose an algorithm for managing knee pain beyond the age of 50 and recommend that authorities review this indicator to prevent further drifts and unnecessary penalization of patients who should receive justified care.
Finally, the application of quotas in accessing specialties have, for the first time, significantly limited the number of candidates entering our specialty. We question these measures, the consequences of which, already visible in general medicine, will presumably be equally damaging in our specialty in a few years, with a significant reduction in the workforce, even though the needs of the population in our sector tend to increase. We are concerned about the perspectives for health in Europe and Belgium.
Keywords
Peripheral nerve injuries, nerve grafts, meniscectomy above 50 years old, gonarthrosis, workforce, medical quotas