Increasing The Rate of Knee Replacement Surgery With Decision Aid

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A decision aid can increase the rate of total knee replacement surgery among black patients with knee OA.
A decision aid can increase the rate of total knee replacement surgery among black patients with knee OA.

HealthDay News -- A decision aid can increase the rate of total knee replacement (TKR) surgery among black patients with knee osteoarthritis (OA), according to a study published online on November 23rd in JAMA Surgery.1

Said A. Ibrahim, M.D., M.P.H., from the University of Pennsylvania Perelman School of Medicine in Philadelphia, and colleagues recruited 336 participants who self-identified as black, aged 50 years and older, with chronic and frequent knee pain and radiographic evidence of OA of the knee

Participants were randomized to either an intervention group that had access to a decision aid for OA of the knee (a 40-minute video describing the risks and benefits of surgery), or to a control group.

The researchers found that 7.7% of control patients and 14.9% of patients in the intervention group underwent TKR within 12 months (P =.04), representing a 70% increase in the TKR rate (86% increase in the per-protocol sample). 

In the intention-to-treat analysis, 15.5% of controls and 20.2% of intervention patients received a recommendation for surgery within 6 months (P =.25). In the per-protocol analysis, the difference between the surgery recommendation rate was not significant (15.6 vs 20.7%; P =.25).

"A decision aid increased rates of TKR among black patients. However, rates of recommendation for surgery did not differ significantly," the authors write. "A patient-centered counseling and educational intervention may help to address racial variations in the use of TKR for the management of end-stage OA of the knee."

 

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Reference

  1. Ibrahim SA, Blum M, Lee GC, et al. Effect of a Decision Aid on Access to Total Knee Replacement for Black Patients With Osteoarthritis of the Knee: A Randomized Clinical Trial. JAMA Surg. 2016;e164225. doi:10.1001/jamasurg.2016.4225
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