Please use this identifier to cite or link to this item: https://doi.org/10.1007/s00167-015-3961-5
Title: The reason why orthopaedic surgeons perform total knee replacement: results of a randomised study using case vignettes
Authors: Verra, WC
Witteveen, KQ
Maier, AB 
Gademan, MGJ
van der Linden, HMJ
Nelissen, RGHH
Keywords: Science & Technology
Life Sciences & Biomedicine
Orthopedics
Sport Sciences
Surgery
Total knee replacement
Indication
Age
Pain
Osteoarthritis
TOTAL JOINT REPLACEMENT
TOTAL HIP
OSTEOARTHRITIS
ARTHROPLASTY
PREDICTORS
AGE
POPULATION
OUTCOMES
Issue Date: 1-Aug-2016
Publisher: SPRINGER
Citation: Verra, WC, Witteveen, KQ, Maier, AB, Gademan, MGJ, van der Linden, HMJ, Nelissen, RGHH (2016-08-01). The reason why orthopaedic surgeons perform total knee replacement: results of a randomised study using case vignettes. KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY 24 (8) : 2697-2703. ScholarBank@NUS Repository. https://doi.org/10.1007/s00167-015-3961-5
Abstract: Purpose: End-stage knee osteoarthritis (OA) results in total knee arthroplasty (TKA) surgery. The decision to perform TKA is not well defined, resulting in variation of indications among orthopaedic surgeons. Non-operative treatment measures are often not extensively used. Aim of this study was to investigate factors influencing the decision to perform TKA by Dutch orthopaedic surgeons. Methods: Three case vignettes, each case divided into two versions, being identical except for information on age (younger and older age), pain (mild and severe pain) or radiological OA (low and high grade) were developed. A questionnaire including these three case vignettes was sent to 599 Dutch orthopaedic surgeons, who were randomised to either one of the two versions. The orthopaedic surgeons were asked whether TKA would be the next step in treatment. Furthermore, from a list of patient factors they were asked how strong these factors would influence the decision to perform TKA. Results: 54 % of the orthopaedic surgeons completed the questionnaire (n = 326). Orthopaedic surgeons indicated to perform TKA significantly more often at higher age (73.3 vs. 45.5 %, p < 0.001). In the presence of mild pain, orthopaedic surgeons were slightly more reluctant to perform a TKA compared to severe pain (57.0 vs. 64.0 %, n.s.). Mild radiological OA made surgeons more reluctant to perform TKA compared to severe OA (9.7 vs. 96.9 %, p < 0.001). Conclusion: Old age and severe radiological OA are variables which are considered to be important in the decision to perform a TKA. Pain symptoms of moderate or severe pain are unequivocal when considering a TKA. Level of evidence: Economic/decision analysis, Level III.
Source Title: KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY
URI: https://scholarbank.nus.edu.sg/handle/10635/234995
ISSN: 0942-2056
1433-7347
DOI: 10.1007/s00167-015-3961-5
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