One-Third of Knee Replacement Patients Improperly Selected
(HealthDay News) — More than one-third of total knee arthroplasty (TKA) surgeries may be inappropriate, according to a study published online June 29 in Arthritis & Rheumatology.
Daniel L. Riddle, PT, PhD, from Virginia Commonwealth University in Richmond, and colleagues examined the prevalence rates of TKA surgeries that were classified as appropriate, inconclusive, or inappropriate using a modified version of validated appropriateness criteria. The criteria were adopted for use on individuals undergoing TKA that were included in the Osteoarthritis Initiative dataset. Preoperative data including Western Ontario and McMaster Universities osteoarthritis pain and physical function scores, radiographic and knee motion and laxity measures, and age were examined for 205 individuals with TKA.
The researchers found that the prevalence rates of appropriate classifications, inconclusive classifications, and inappropriate classifications were 44.0, 21.7, and 34.3%, respectively.
"These data support the need for consensus development of criteria for patient selection among practitioners in the United States treating potential TKA candidates," the authors write. "Among the important issues, consensus development needs to address variation in patient characteristics and the relative importance of preoperative status and subsequent outcome."
The Osteoarthritis Initiative is partially funded by pharmaceutical companies.