Agreement about indications for total knee arthroplasty
Agreement about indications for total knee arthroplasty
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DOI：
10.1097/01.blo.0000214436.49527.5e
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发表时间：
2006-05-01
影响因子：
4.2
通讯作者：
Kane, Robert L.
中科院分区：
文献类型：
--
作者：
Cross, William W., III;Saleh, Khaled J.;Kane, Robert L.
全膝关节置换术是一种有效且具有成本效益的手术，可改善终末期膝关节炎患者的生活质量。随着人口老龄化，关节炎的患病率预计将增加，全膝关节置换术的需求将大幅增加。我们通过回顾从Medline全面检索中提取的文章来检查全膝关节置换术的当前适应症。我们研究了进行全膝关节置换术的适应症，转诊患者进行全膝关节置换术的适应症，以及骨科医生、风湿病学家和初级保健提供者的禁忌症。我们评估了27-42种不同的患者因素。“疼痛对药物治疗无反应”是全膝关节置换术唯一的共识因素。“严重精神疾病，包括痴呆”是唯一达成共识的全膝关节置换术禁忌症。骨科内部和各专业之间缺乏共识可能代表了与全膝关节置换术结局相关的经验数据的局限性。要达成更好的共识，需要对预测全膝关节置换术成功的患者特征进行更好的研究并传播。
Total knee arthroplasty is an effective and cost efficient procedure that improves the quality of life for patients with end stage knee arthritis. With the prevalence of arthritis expected to increase with the aging of the population, the demand for total knee arthroplasty will increase substantially. We examined current indications for total knee arthroplasty by reviewing articles extracted from a comprehensive Medline search. We studied the indications for proceeding with a total knee arthroplasty, the indications for referring a patient for a total knee arthroplasty, and the contraindications among orthopaedic surgeons, rheumatologists, and primary care providers. We evaluated 27-42 different patient factors. "Pain not responsive to drug therapy" was the only factor with consensus for total knee arthroplasty. "Major psychiatric disorder, including dementia" was the only contraindication to total knee arthroplasty that had a consensus. The lack of consensus within orthopaedics and across specialties likely represents a limitation in empirical data associated with total knee arthroplasty outcomes. Achieving better consensus will require conducting and disseminating better research on patient characteristics that predict the success of total knee arthroplasty.