Total knee arthroplasty in motivated patients with knee osteoarthritis and athletic activity approach type goals: a conceptual decision-making model.
Knee osteoarthritis is one of the most common disabling medical conditions. With longer life expectancy the number of total knee arthroplasty (TKA) procedures being performed worldwide is projected to increase dramatically. Patient education, physical activity, bodyweight levels, expectations and goals regarding the ability to continue athletic activity participation are also increasing. For the subset of motivated patients with knee osteoarthritis who have athletic activity approach type goals, early TKA may not be the best knee osteoarthritis treatment option to improve satisfaction, quality of life and outcomes. The purpose of this clinical commentary is to present a conceptual decision-making model designed to improve the knee osteoarthritis treatment intervention outcome for motivated patients with athletic activity approach type goals. The model focuses on improving knee surgeon, patient and rehabilitation clinician dialogue by rank ordering routine activities of daily living and quality of life evoking athletic activities based on knee symptom exacerbation or re-injury risk. This process should help establish realistic patient expectations and goals for a given knee osteoarthritis treatment intervention that will more likely improve self-efficacy, functional independence, satisfaction and outcomes while decreasing the failure risk associated with early TKA.
Department of Orthopaedic Surgery, University of Louisville, Louisville 40202, USA. john.nyland@louisville.edu
John
J
Nyland
Zachary
Z
Kanouse
Ryan
R
Krupp
David
D
Caborn
Rolie
R
Jakob
D000203:Activities of Daily Living; D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D003657:Decision Making; D015444:Exercise / Q000502:physiology* / Q000523:psychology*; D005260:Female; D006040:Goals; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D020370:Osteoarthritis, Knee / Q000601:surgery*; D017060:Patient Satisfaction; D011788:Quality of Life; D020127:Recovery of Function; D020377:Self Efficacy; D016896:Treatment Outcome