title: Is the treatment gap in knee osteoarthritis real? A qualitative study of surgeons' perceptions.
abstract: BACKGROUND
  Knee osteoarthritis (OA) is a chronic condition characterized by loss of joint cartilage that leads to persistent pain, loss of function, and disability. It has been reported that a treatment gap exists in a subset of knee OA patients who are unresponsive to conservative treatment yet are unsuitable for or unwilling to undergo more invasive, irreversible, surgical procedures.
  
  
  METHODS
  Ten orthopedic healthcare professionals participated in a focus group (n=5) and semistructured interviews (n=5). We explored their perceptions on the treatment gap in knee OA patients and their opinions of the KineSpring® Knee Implant System.
  
  
  RESULTS
  Among the responses of orthopedic healthcare professionals, we identified seven themes: (1) Delaying operative treatment for knee OA patients is very important. (2) Unrealistic expectations of younger patients play an important role in management of knee OA. (3) A treatment gap does exist. (4) Management of knee OA should be tailored to the individual patient. (5) The ability to delay total knee replacement without compromising the ability to do it in the future is important for the acceptance of the KineSpring System. (6) Improving patient lives by decreasing pain, improving function, and potentially delaying arthroplasty is important. (7) A well-designed randomized control trial and further evidence regarding the KineSpring System is desired.
  
  
  CONCLUSIONS
  Orthopedic healthcare professionals are enthusiastic about the prospect of the KineSpring System as an option to help close the treatment gap in knee OA. Focusing only on clinical trials with long-term data may be impractical and deprive patients and society of benefits that can be gained while trial data are maturing.
authors.affiliation: Global Research Solutions, Inc., Burlington, Ontario, Canada.
authors.forename: Chuan Silvia
authors.initials: CS
authors.lastname: Li
authors.affiliation: Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Rubini
authors.initials: R
authors.lastname: Pathy
authors.affiliation: Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Anthony
authors.initials: A
authors.lastname: Adili
authors.affiliation: Juravinski Hospital and Cancer Centre, Hamilton, Ontario, Canada.
authors.forename: Victoria
authors.initials: V
authors.lastname: Avram
authors.affiliation: Orthopedic Surgery, James Paton Memorial Hospital, Gander, Newfoundland, Canada.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Barasi
authors.affiliation: Divisions of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Raman
authors.initials: R
authors.lastname: Mundi
authors.affiliation: Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Gavinn
authors.initials: G
authors.lastname: Niroopan
authors.affiliation: CLARITY Research Group, McMaster University, Department of Orthopedic Surgery Musculoskeletal Research Unit, Canada and Division of Orthopaedic Surgery and Department of Clinical Epidemiology & Biostatistics, Hamilton General Hospital, Canada.
authors.forename: Mohit
authors.initials: M
authors.lastname: Bhandari
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D007719:Knee Joint / Q000601:surgery; D007720:Knee Prosthesis; D008297:Male; D020370:Osteoarthritis, Knee / Q000628:therapy*