Is Knee Replacement the Best Course? BEST Knee Study Will Help Surgeons Assess Likelihood of Patient Benefit

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Close to 2,800 Albertans with painful knee arthritis have been recruited to a study that is developing more accurate ways to determine who is suitable for knee replacement and who should use other methods to manage the pain and stiffness in their knees.

Called BEST Knee, the study will develop and validate criteria that will help surgeons and their patients assess the likelihood of benefit from knee replacement and, thus, the patients’ appropriateness for surgery. Patients participating in BEST Knee will be followed to assess their pain, function and satisfaction at six months and one year following surgery. ABJHI is managing the data for the study.

In work unrelated to BEST Knee, a preliminary analysis of data by ABJHI suggested 15% to 30% of knee replacement patients derived little to no benefit from their surgery and expressed dissatisfaction with their outcomes. These findings were consistent with those of a Virginia Commonwealth University study that found one-third of knee replacements in the United States were inappropriate and the patients experienced little to no benefit from their surgery.

Patients in the BEST Knee study were recruited from the Edmonton Musculoskeletal Centre and Calgary’s Alberta Hip and Knee Clinic.

BEST Knee, the abbreviated name for the Best Evidence for Surgical Treatment in Knee Osteoarthritis study, is funded by a grant from the Canadian Institutes of Health Research. The work is being led by Drs. Deborah Marshall and Gillian Hawker. Dr. Marshall is ABJHI’s Director of Health Technology Assessment and Research, the Canada Research Chair of Health Services and Systems Research, and a member of the McCaig Institute for Bone and Joint Health. 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.