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Indications for hip and knee replacement in Sweden
Sofia Löfvendahl1, Svetlana Bizjajeva, Jonas Ranstam
1Swedish National Musculoskeletal Competence Centre (NKO), Lund University Hospital, Lund University, Lund, Sweden. sol@nko.se
Journal of Evaluation in Clinical Practice
|September 24, 2010
Summary
This study found significant variations in hip and knee replacement indications across Swedish hospitals, despite most patients having severe osteoarthritis. A clinical priority tool helps track these changes and explain case mix differences.
Area of Science:
- Orthopaedic Surgery
- Health Services Research
Background:
- Hip and knee replacements are common procedures for osteoarthritis (OA).
- Standardized criteria for patient selection are crucial for consistent care and outcome evaluation.
Purpose of the Study:
- To compare indication parameters for hip and knee replacement surgeries across Swedish orthopaedic units.
- To assess the utility of a Swedish priority criteria tool in evaluating patient selection for joint replacement.
Main Methods:
- A 2-year study (2006-2008) involving 11 Swedish orthopaedic clinics.
- Included 2961 patients undergoing hip (1662) or knee (1299) replacement for osteoarthritis.
- Utilized a validated Swedish priority criteria tool with patient and doctor questionnaires.
Main Results:
- Most patients presented with severe clinical and radiological osteoarthritis.
- Patients reported significant pain at rest, mobility issues, and impaired daily activities.
- Statistically significant differences in reported indications were observed between hospitals for both hip and knee OA.
Conclusions:
- A clinical priority criteria tool effectively monitors changes in surgical indications.
- This tool can help explain variations in case mix when assessing clinical outcomes and patient satisfaction.
