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Use of a validated algorithm to judge the appropriateness of total knee arthroplasty in the United States: a multicenter longitudinal cohort study.

Publication ,  Journal Article
Riddle, DL; Jiranek, WA; Hayes, CW
Published in: Arthritis Rheumatol
August 2014

OBJECTIVE: In previous studies conducted outside the US, ∼20% of total knee arthroplasty (TKA) surgeries were judged to be inappropriate. The present study was undertaken to determine the prevalence rates of TKA surgeries classified as appropriate, inconclusive, and inappropriate in a knee osteoarthritis population in the US. METHODS: We used a modification of a validated appropriateness classification system and applied it to patients in the Osteoarthritis Initiative data set who underwent TKA. A variety of preoperative data were used in the classification, including Western Ontario and McMaster Universities Osteoarthritis Index pain and physical function scores, radiographic features, knee motion and laxity measures, and age. RESULTS: Data on 205 patients who underwent TKA were examined. The prevalence rates for classification of the procedure as appropriate, inconclusive, and inappropriate were 44.0% (95% confidence interval [95% CI] 37-51%), 21.7% (95% CI 16-28%), and 34.3% (95% CI 27-41%), respectively. CONCLUSION: Approximately one-third of TKA surgeries were judged to be inappropriate. Variation in the characteristics of patients undergoing TKA was extensive. These data support the need for consensus development of criteria for patient selection among US practitioners treating patients who are potential candidates for TKA. Among the important issues, consensus development needs to address variation in patient characteristics and the relative importance of preoperative status and subsequent outcome.

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Published In

Arthritis Rheumatol

DOI

EISSN

2326-5205

Publication Date

August 2014

Volume

66

Issue

8

Start / End Page

2134 / 2143

Location

United States

Related Subject Headings

  • Young Adult
  • Unnecessary Procedures
  • United States
  • Reproducibility of Results
  • Patient Selection
  • Middle Aged
  • Male
  • Humans
  • Female
  • Cohort Studies
 

Citation

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Riddle, D. L., Jiranek, W. A., & Hayes, C. W. (2014). Use of a validated algorithm to judge the appropriateness of total knee arthroplasty in the United States: a multicenter longitudinal cohort study. Arthritis Rheumatol, 66(8), 2134–2143. https://doi.org/10.1002/art.38685
Riddle, Daniel L., William A. Jiranek, and Curtis W. Hayes. “Use of a validated algorithm to judge the appropriateness of total knee arthroplasty in the United States: a multicenter longitudinal cohort study.Arthritis Rheumatol 66, no. 8 (August 2014): 2134–43. https://doi.org/10.1002/art.38685.
Riddle, Daniel L., et al. “Use of a validated algorithm to judge the appropriateness of total knee arthroplasty in the United States: a multicenter longitudinal cohort study.Arthritis Rheumatol, vol. 66, no. 8, Aug. 2014, pp. 2134–43. Pubmed, doi:10.1002/art.38685.
Journal cover image

Published In

Arthritis Rheumatol

DOI

EISSN

2326-5205

Publication Date

August 2014

Volume

66

Issue

8

Start / End Page

2134 / 2143

Location

United States

Related Subject Headings

  • Young Adult
  • Unnecessary Procedures
  • United States
  • Reproducibility of Results
  • Patient Selection
  • Middle Aged
  • Male
  • Humans
  • Female
  • Cohort Studies