One-third of knee replacements in the US classified as inappropriate

More than one-third of total knee replacements in the US have been classified as “inappropriate” using a patient classification system developed and validated in Spain, says research published in Arthritis & Rheumatology.
The study highlights the need for consensus on who should receive knee replacements.
Over 600,000 knee replacements are performed in the US each year according to The Agency for Healthcare Research and Quality, and numbers are increasing.
Total knee replacement in the US more than doubled from 1999 to 2008. Some experts say the growth is due to use of an effective procedure but other suggest that there is over-use of the surgery that relies on subjective criteria.
The current study found the average age of people having a knee replacement was 67 years and 60% of the group was female. Analyses show that 44% of surgeries were classified as appropriate, 22% as inconclusive, and 34% inappropriate.
“Our finding that one third of knee replacements were inappropriate was higher than expected and linked to variation in knee pain osteoarthritis severity and functional loss,” says Dr Daniel Riddle, who led the work. “These data highlight the need to develop patient selection criteria in the US.”
Meanwhile, in the UK Arthritis Research UK is funding a study that is designed to predict how individuals will respond to knee replacement surgery, enabling people to make an informed decision whether to go ahead with it or not.