Support tool could aid decision on total joint arthroplasty

(HealthDay)—A decision-support tool would help with decision making for total joint arthroplasty (TJA) for patients with osteoarthritis, according to a study published online Sept. 8 in the Journal of Evaluation in Clinical Practice.

Lucy Frankel, from Women's College Hospital in Toronto, and colleagues conducted semi-structured telephone interviews of orthopedic surgeons in three Canadian provinces to determine surgeons' criteria for TJA appropriateness for osteoarthritis.

The researchers found, based on the responses of 14 of 17 approached participants (12 males; five academic), that pain and pain impact on patients' quality of life and function were the key criteria to assess appropriateness for TJA. However, the respondents acknowledged that these factors are difficult to assess and not always tied to structural changes on joint radiography. Patient age may affect appropriateness, the surgeons said. Most of the surgeons agreed that a decision-support tool would aid standardization of assessment, but they said the ultimate decision must be left to the discretion of surgeons, within the context of the doctor-patient relationship.

"Surgeons recognized the need for a tool to support decision making for TJA, particularly in the context of increasing surgical demand in younger patients with less severe arthritis," write the authors.

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