title: Surgeon age as the major factor in recommendation of uni-compartmental knee replacement versus high tibial osteotomy: a case study in orthopaedic decision making.
abstract: This case report concerns surgical decision making. The subject is a 59 year old male orthopaedic surgeon with medial compartment knee arthritis. Both high tibial valgus osteotomy and uni-compartmental knee replacement would be appropriate with similar outcomes reported in the literature. Surprisingly, almost all young surgeons recommended a uni-compartmental knee replacement and almost all older surgeons recommended a high tibial osteotomy. We discuss the reasons that surgeon age, which is clearly irrelevant to the optimal decision, is the dominant determinant of surgical recommendation for this patient.
authors.affiliation: Frederick R Dietz, MD Department of Orthopaedic Surgery University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA.
authors.forename: Frederick R
authors.initials: FR
authors.lastname: Dietz
authors.forename: Mark G
authors.initials: MG
authors.lastname: Kelman
mesh_terms: D000367:Age Factors; D019645:Arthroplasty, Replacement, Knee / Q000523:psychology; D002983:Clinical Competence; D003657:Decision Making; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000601:surgery*; D010027:Osteotomy / Q000523:psychology; D011859:Radiography; D016896:Treatment Outcome