Predictive Tool Use and Willingness for Surgery in Patients With Knee Osteoarthritis: A Randomized Clinical Trial

Area of Science:

• Orthopedic Surgery
• Health Informatics
• Patient Decision-Making

Background:

• Predictive tools for total knee arthroplasty (TKA) are increasingly available, yet their impact on patient choices is unclear.
• Patient decision-making for TKA requires reliable information on potential outcomes.

Purpose of the Study:

• To evaluate the effect of an online predictive tool on patients' reported willingness to undergo TKA.
• To assess how predictive information influences the decision-making process for knee replacement surgery.

Main Methods:

• A parallel, double-masked, randomized clinical trial compared an online predictive tool group with a treatment-as-usual (TAU) control group.
• Participants with knee osteoarthritis contemplating TKA were recruited from insurance and public hospital waitlists.
• The primary outcome was willingness for surgery at 6 months, with secondary outcomes including treatment preference and decision quality.

Main Results:

• The study included 211 participants (mean age 65.8 years, 55.9% female).
• The online predictive tool did not significantly reduce participants' willingness for TKA at 6 months (adjusted odds ratio, 0.85; P=.64).
• No significant difference was found in willingness for surgery between the predictive tool and TAU groups.

Conclusions:

• The tested online predictive tool did not influence patients' willingness to undergo TKA.
• Predictive tools may still offer benefits for patients with knee osteoarthritis, potentially enhancing health outcomes.
• Further research is necessary to refine the design and application of predictive tools for TKA decision support.