ABJHI Supporting Design of Tools to Determine Patient Appropriateness for Knee Replacement

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ABJHI is providing information that will help a research team design new methodologies for determining whether a patient is a suitable candidate for knee replacement.

Called BEST Knee, the study involves developing and validating criteria that will help physicians and their patients assess the likelihood of benefit from knee replacement and, thus, the patients’ appropriateness for surgery.

The study will benefit Albertans by helping to ensure patients who have a knee replacement actually need the surgery and will benefit from it. Preliminary data analyzed by ABJHI suggest 15% to 30% of knee replacement patients derive little to no benefit from their surgery and, as would be expected, express disappointment with their outcomes. These findings are consistent with those of a Virginia Commonwealth University study that found one-third of knee replacements in the United States were inappropriate. The findings suggest the patients had surgery that was not necessary at the time and should have first received other types of treatment to alleviate the pain and stiffness in the joint. The U.S. researchers found the patients who had inappropriate surgery experienced little to no benefit from their knee replacement.

BEST Knee is funded by a grant from the Canadian Institutes of Health Research. The work is being led by Drs. Gillian Hawker and Deborah Marshall. Dr. Hawker is Chair of the Department of Medicine at the University of Toronto and holds the F.M. Hill Chair in Academic Women’s Medicine. Dr. Marshall is the Canada Research Chair of Health Services and Systems Research and ABJHI’s Director of Health Technology Assessment.