Patient appropriateness for total knee arthroplasty and predicted probability of a good outcome

Review written by Dr Anthony Teoli info

Key Points

  1. Patient-reported measures of “total knee arthroplasty (TKA) readiness/willingness” and “TKA expectations” assessed pre-operatively significantly enhanced the ability to discriminate those who did versus those who did not go on to experience a good TKA outcome compared with measures of “TKA need” alone.
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BACKGROUND & OBJECTIVE

Approximately 20% of patients report persistent pain following their total knee arthroplasty (TKA) (1). Previous research has examined various TKA appropriateness criteria (patients’ symptoms, comorbidity, radiographic severity, and clinical examination) to determine whether it is reasonable to consider proceeding with the operation given a patient’s particular circumstances (2,3). However, no criteria explicitly incorporate patients’ expectations or preferences for care.

Therefore, the objective of this study was to determine the ability of four appropriateness domains (TKA need, health status, readiness and willingness and surgical expectations) to discriminate, preoperatively, those who would versus those who would not experience a good outcome following TKA.

Approximately 20% of patients report persistent pain following their total knee arthroplasty.
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Patients with knee osteoarthritis who are awaiting a total knee arthroplasty should be provided with all the necessary information to weigh the potential benefits and risks of surgery and make an informed decision.

METHODS

  • The following four domains were assessed preoperatively:
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