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| Dr. Daniel Riddle, Virginia Commonwealth University |
For the first time, researchers have examined if knee replacement surgeries comply with criteria validating their appropriateness. They found that more than one-third of knee replacement surgeries in the U.S. were inappropriate using a patient classification system. Researchers cited the need to develop patient selection criteria for knee replacements in the U.S.
The study looked at 175 subjects who had undergone total knee replacement surgery and then it classified their surgeries as appropriate, inconclusive or inappropriate based on an appropriateness classification system developed in Spain as well as pain and physical function scales. All the participants were enrolled in the Osteoarthritis Initiative, a prospective 5-year study funded in part by the National Institutes of Health.
In 34% of evaluated surgeries the knee replacement were found to be inappropriate by these criteria, with another 22% deemed inconclusive. Only 44% of the surgeries were classified as appropriate. The researchers had expected to find a rate of about 20% of surgeries to be inappropriate.
"Our finding that one third of knee replacements were inappropriate was higher than expected and linked to variation in knee pain OA severity and functional loss. These data highlight the need to develop patient selection criteria in the U.S.," concludes study lead author Dr. Daniel Riddle from the Department of Physical Therapy at Virginia Commonwealth University in Richmond.
The mean age of knee replacement patients was 67 years and 60% of the group was female. The study was published in Arthritis & Rheumatology, a journal of the American College of Rheumatology.
There are more than 600,000 knee replacements annually in the U.S., according to the Agency for Healthcare Research and Quality. And the annual volume of Medicare-covered knee replacement surgeries grew by 162% from 1991 to 2010, the study noted.
- here is the release
- and here is the study