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Table 2 Reviews on indication criteria concerning total hip arthroplasty and total knee arthroplasty

From: Indication criteria for total hip or knee arthroplasty in osteoarthritis: a state-of-the-science overview

Author

Year of publication

Study group region

Systematic review

Evidence

Indication criteria

Pain

Function

Radiological changes

Failed or futile conservative therapy

Other criteria

Knee

         

Hanssen [34]

2000

USA

No

Level IV

    

As the indications continue to expand, the decision to proceed with total knee arthroplasty in young, active patients’ needs to be individualized after careful consideration of alternatives.

Kirschner [44]

2011

Germany

No

Level IV

Pain during activities or rest

 

Radiologic evidence of arthritis

  

van Manen [30]

2012

USA

No

Level IV

Severe, refractory knee pain, often at night

Difficulty with activities of daily living; decreased mobility

Radiographic evidence of primary or inflammatory degenerative joint disease: Narrowed joint space; osteophytes (spurring) and bone cysts; squaring of condyles; bone sclerosis

Failure to respond to conservative measures

Current health status: Medically optimized for surgery; no evidence of infection; intact extensor mechanism; informed consent obtained

Medical Advisory Secretariat [26]

2005

Canada

Yes

Level IV

Pain

Functional ability

   

Schneppenheim [28]

2001

Germany

No

Level IV

Debilitating pain

Severe restrictions on the activities of the patients in daily life

Significant radiographic findings

Yes

 

Hip

         

Kirschner [43, 44]

2011

Germany

No

Level IV

Hip: pain during activities or rest

Constricted range of motion

Radiologic evidence of arthritis

  

Lane [33]

2007

USA

No

Level IV

 

Substantial functional impairment

  

Chronic discomfort

Levine [31]

2013

USA

No

Level IV

Pain refractory to nonsurgical management

Functional impairment

Radiographic findings (joint space narrowing, bone sclerosis, bone cysts femoral/ acetabular osteophytes

Yes

Physical exam findings (groin pain and decreased internal rotation), ruled out causes of referred pain including spine problems and bursitis

Passias [32]a

2006

USA

No

Level IV

Incapacitating pain not responsive to conservative therapy

Function limiting symptoms: a significant deterioration in the ability to perform certain activities that are deemed important to the patient, and major lifestyle changes

Evidence of joint degeneration

Yes

 

Pivec [14]

2012

USA

No

Level IV

Pain

Functional impairment

Radiographic findings

 

Initial course of conservative therapy should always be attempted with analgesia, activity modification, ambulatory aids, and weight loss.

Knee and Hip

Altman [25]

2005

USA, France, Portugal, Belgium, Spain, Germany, Austria, Czech Republic, The Netherlands

Yes

Level III

    

The criteria for when to perform such surgery are not clear.

Dowsey [27]

2014

Australia

No

Level III

    

Selection of suitable candidates for TJA is critical but appropriate criteria are not clearly defined.

Mandl [29]

2013

USA

No

Level IV

    

There are no definitive recommendations for deciding which patients should be referred for TJA.

  1. Legend: TJA: total joint arthroplasty
  2. aThis study focusses on THA in older people (>65 years of age)