Examining timing of TKA

Editor's Note

The timing of total knee arthroplasty (TKA) is important to optimize its benefits, but 90% of patients are waiting too long to have it and getting less benefits, and some 25% of patients are having it prematurely when the benefits are  minimal, this study finds.

Of 3,417 knees analyzed:

• 290 were classified as timely for which replacement was potentially appropriate
• 2,833 were classified as potentially appropriate but not replaced
• 294 were considered to be likely inappropriate but had knee replacement and were classified as premature.

Of knees that were potentially appropriate but were not replaced, 1,204 had severe symptoms.

The ideal timing of TKA is based on an algorithm that factors in pain, joint function, radiographic assessment, and age to determine if a patient will benefit from surgery, the authors say.

This is believed to be the first study to prospectively examine the timeliness of TKA in a large number of patients with knee osteoarthritis who could benefit from surgery.