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[When should we perform a knee or hip arthroplasty?]

Anna-Katharina Calek1, Henrik Behrend1

  • 1Klinik für orthopädische Chirurgie und Traumatologie des Bewegungsapparates, Kantonsspital St. Gallen.

Therapeutische Umschau. Revue Therapeutique
|December 4, 2020
PubMed
Summary

The optimal timing for total hip (THA) and knee (TKA) arthroplasty involves considering patient pain, quality of life limitations due to osteoarthritis, and failed conservative treatments. Patient suffering ultimately guides the decision for surgery.

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Area of Science:

  • Orthopedic Surgery
  • Rheumatology
  • Biomedical Engineering

Background:

  • Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are highly successful orthopedic procedures.
  • These surgeries significantly enhance patient quality of life and satisfaction.
  • Determining the optimal timing for arthroplasty is crucial for achieving favorable outcomes.

Purpose of the Study:

  • To define the key indications and optimal timing for performing hip and knee arthroplasties.
  • To outline the criteria that should be met for a successful arthroplasty indication.
  • To emphasize the role of patient-reported outcomes in surgical timing.

Main Methods:

  • Review of clinical guidelines and best practices for arthroplasty indications.
  • Analysis of factors influencing surgical outcomes in THA and TKA.
  • Integration of patient-reported pain, functional limitations, and quality of life metrics.

Main Results:

  • Successful arthroplasty requires a combination of symptomatic osteoarthritis, radiographic confirmation, and failure of conservative management.
  • A thorough medical history, clinical examination, and radiographic assessment are essential.
  • Realistic patient expectations and the degree of patient suffering are paramount in decision-making.

Conclusions:

  • The decision to proceed with THA or TKA should be individualized based on a comprehensive evaluation.
  • A differentiated indication, considering objective findings and subjective patient experience, leads to better outcomes.
  • Patient suffering and discomfort are the ultimate determinants for the timing of arthroplasty.