Perspectives of orthopaedic surgeons on patients' appropriateness for total joint arthroplasty: a qualitative study

Journal of Evaluation in Clinical Practice
L FrankelTom Noseworthy

Abstract

As total joint arthroplasty (TJA) rates rise, there is need to ensure appropriate use. Our objective was to elucidate surgeons' perspectives on appropriateness for TJA. Semi-structured telephone interviews were conducted in a sample of orthopaedic surgeons that perform TJA in three Canadian Provinces. Surgeons were asked to discuss their criteria for TJA appropriateness for osteoarthritis; potential value of a decision-support tool to select appropriate candidates; and the role of other stakeholders in assessing appropriateness. Of 17 surgeons approached for participation, 14 completed interviews (12 males; 7 aged <50 years; 5 academic; 8 in urban practices). Surgeons agreed that pain and pain impact on patients' quality of life and function were the key criteria to assess appropriateness for TJA, but that these concepts were difficult to assess and not always congruent with structural changes on joint radiography. Some used a wider range of criteria, including their assessments of patient expectations, ability to cope and readiness for surgery. While patient age was not identified as a criterion itself, surgeons did acknowledge that appropriateness criteria may differ for younger versus older patients. Most agreed that a decis...Continue Reading

References

May 1, 1989·Seminars in Arthritis and Rheumatism·N Bellamy
Jun 1, 1997·The Journal of Arthroplasty·C A MancusoM E Charlson
Apr 6, 2000·The New England Journal of Medicine·G A HawkerE M Badley
May 2, 2001·Osteoarthritis and Cartilage·C J BachmeierUNKNOWN Arthritis Cost and Outcome Project Group
May 9, 2001·The Journal of Bone and Joint Surgery. British Volume·M J DunbarL Lidgren
Apr 19, 2003·International Journal of Technology Assessment in Health Care·Antonio EscobarIdoia Garai
Dec 4, 2003·Clinical Orthopaedics and Related Research·Victoria A BranderTimothy Houle
May 1, 2004·The Journal of Bone and Joint Surgery. American Volume·Olivier EthgenJean-Yves Reginster
Jan 25, 2006·Archives of Internal Medicine·José M QuintanaJuan C Arenaza
Mar 21, 2007·Rheumatic Diseases Clinics of North America·C Allyson JonesMaria E Suarez-Almazor
Jan 1, 2008·Arthritis and Rheumatism·Reva C LawrenceUNKNOWN National Arthritis Data Workgroup
Jul 8, 2008·International Journal of Technology Assessment in Health Care·Claudia SanmartinTom Noseworthy
Aug 15, 2008·The Journal of Arthroplasty·Rajiv GandhiNizar Mahomed
Oct 22, 2009·Clinical Orthopaedics and Related Research·Robert B BourneKory D J Charron
Sep 21, 2010·BMC Musculoskeletal Disorders·Rachael Gooberman-HillJenny L Donovan
Apr 27, 2011·International Journal of Rheumatic Diseases·Paul DieppeStefan Lohmander
Jul 7, 2011·BMC Musculoskeletal Disorders·Karen R SepuchaCarrie A Levin
Jan 25, 2012·PloS One·Claire JourdanPhilippe Ravaud
Jun 5, 2012·Osteoarthritis and Cartilage·L FrankelG A Hawker
Jun 27, 2012·The Journal of Bone and Joint Surgery. British Volume·C E H ScottL C Biant
Jul 24, 2012·Clinical Orthopaedics and Related Research·Hassan M K GhomrawiUNKNOWN Expectations Discordance Study Group
Oct 2, 2012·HSS Journal : the Musculoskeletal Journal of Hospital for Special Surgery·Hassan M K GhomrawiAlejandro Gonzalez Della Valle
Dec 12, 2012·Best Practice & Research. Clinical Rheumatology·Bheeshma RaviGillian A Hawker
Dec 28, 2012·The New England Journal of Medicine·Hassan M K GhomrawiAlvin I Mushlin
Jun 8, 2013·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Jasvinder A Singh, David G Lewallen

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Citations

Nov 20, 2019·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Barbara L Conner-SpadyTom W Noseworthy
Sep 3, 2019·The Journal of Rheumatology·Susan M Goodman, Peter K Sculco
Feb 23, 2021·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Femke AtsmaGert P Westert
Mar 31, 2021·Journal of Orthopaedic Surgery and Research·Antonio EscobarDaniel L Riddle

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