Study says one-third of U.S. knee replacements “inappropriate”

A new analysis from Virginia Commonwealth University in Richmond has found that as many as one-third of total knee replacements in the U.S. may be “inappropriate” when compared with a credible Spanish classification system.

The classification system used in the study was developed in Spain and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) Pain and Physical Function Scale; its criteria are regarded by industry as one of the more powerful tools for improving quality of care.  In the study, the researchers used the classification system and assessed data on 175 adults with an average age of 67 who underwent total knee arthroplasties (TKA).

The findings, published in Arthritis & Rheumatology, showed that 44 percent of the knee surgeries were classified as “appropriate,” while 22 percent were “inconclusive,” and 34 percent were “inappropriate.” Researchers said that the finding that one-third of knee replacements were inappropriate was higher than expected.

Researchers concluded that the study highlights the need for health care providers to be more selective and consider a wider range of variables when it comes to which patients receive total knee replacements.  More than 600,000 total knee replacements are now done in the U.S. every year.

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