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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
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  
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)