Total knee arthroplasty (TKA) is a routine, cost-effective treatment for end-stage arthritis. While the evidence for good-to-excellent patient-reported outcomes and objective clinical data is present, approximately 20% of patients continue to be dissatisfied with results of their surgery. Dissatisfaction is strongly correlated with unmet patient expectations, and these patients may experience a higher cost of care due to recurring office and emergency visits. Therefore, this survey asked a large group of United States (U.S) and international surgeons to prioritize areas of opportunity in primary TKA. Specifically, we compared surgeon responses regarding: 1) the top 5 areas needing improvement; which were stratified by: 2) surgeons' years of experience; and 3) surgical case volume. A total of 418 orthopaedic surgeons were surveyed. Two hundred U.S. surgeons and 218 international surgeons participated from 7 different countries including: The United Kingdom (40), France (40), Germany (43), Italy (40), Spain (38), and Australia (17). To participate, surgeons had to be board certified, in practice for 2 years, spend 60% of their time in clinical practice, and perform a minimum of 25 joint arthroplasties per year. Surgeons were asked to choose the top 5 areas of improvement for TKA from a list of 17 attributes including clinical and functional outcomes, procedural workflow and economic variables. Surgeons were able to specify additional options if needed. Results were stratified by annual case volume (25 to 50; 51 to 100; greater than 100 cases) and years of experience (1 to 10; 11 to 20; greater than 20). Single-tail proportion tests were used to compare results between cohorts, where an alpha of 0.05 was set as significant.Background
Methods
