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Agreement about indications for total knee arthroplasty
William W Cross1, Khaled J Saleh, Timothy J Wilt
1Department of Orthopaedic Surgery, University of Minnesota Medical School, Minneapolis, MN, USA.
Clinical Orthopaedics and Related Research
|May 5, 2006
Summary
Total knee arthroplasty (TKA) is recommended for arthritis pain unresponsive to medication. Major psychiatric disorders are the only contraindication, highlighting the need for more research on TKA success factors.
Area of Science:
- Orthopaedic Surgery
- Rheumatology
- Health Services Research
Background:
- Total knee arthroplasty (TKA) significantly improves quality of life for end-stage knee arthritis patients.
- Increasing arthritis prevalence necessitates understanding TKA indications.
- Demand for TKA is projected to rise due to an aging population.
Purpose of the Study:
- To review current indications and contraindications for TKA.
- To identify consensus among orthopaedic surgeons, rheumatologists, and primary care providers regarding TKA patient selection.
- To evaluate patient factors influencing TKA decisions.
Main Methods:
- Comprehensive Medline search to identify relevant articles.
- Review of indications for proceeding with and referring for TKA.
- Evaluation of 27-42 distinct patient factors.
- Analysis of consensus among different medical specialties.
Main Results:
- "Pain not responsive to drug therapy" was the sole consensus indication for TKA.
- "Major psychiatric disorder, including dementia" was the only consensus contraindication.
- Significant lack of consensus observed across specialties regarding TKA indications and contraindications.
Conclusions:
- The limited consensus suggests a need for more empirical data on TKA outcomes.
- Further research is required to identify patient characteristics predicting successful TKA.
- Improved consensus will enhance patient selection and optimize TKA effectiveness.