Victor Rex Carlson1, Alvin Chua Ong, Fabio Ramiro Orozco, Victor Hugo Hernandez, Rex William Lutz, Zachary Douglas Post. 1. From the Department of Orthopaedics, University of Utah School of Medicine, Salt Lake City, UT (Dr. Carlson), The Rothman Institute of Orthopaedics at Thomas Jefferson University, Egg Harbor Township, NJ (Dr. Ong, Dr. Orozco, and Dr. Post), the Department of Orthopaedics, University of Miami School of Medicine, Miami, FL (Dr. Hernandez), and the Philadelphia College of Osteopathic Medicine, Philadelphia, PA (Mr. Lutz).
Abstract
INTRODUCTION: The American Academy of Orthopaedic Surgeons (AAOS) published a series of evidence-based guidelines for treatment of knee osteoarthritis (OA). We studied compliance with these guidelines among orthopaedic surgeons. METHODS: We sent a survey to members of the American Association of Hip and Knee Surgeons. It included five clinical vignettes based on the Kellgren-Lawrence radiographic system for classification of knee OA. Respondents selected treatment currently supported or not supported by the AAOS guidelines. RESULTS: Of 345 responses, the frequency of use of recommended interventions was 80%, 82%, 21%, 50%, and 98% for OA at stages 0 through 4, respectively. For stage 2 and stage 3 OA, intra-articular hyaluronic acid was the most commonly selected intervention not recommended by the AAOS. DISCUSSION: Apparently, AAOS guidelines on the treatment of OA have not reached the orthopaedic community, resulting in lack of treatment consensus and continued use of modalities with no proven patient benefits. CONCLUSIONS: Management of moderate to severe knee OA does not align with AAOS guidelines. We encourage researchers to conduct clinical trials to identify the role of intra-articular corticosteroids in treating this condition.
INTRODUCTION: The American Academy of Orthopaedic Surgeons (AAOS) published a series of evidence-based guidelines for treatment of knee osteoarthritis (OA). We studied compliance with these guidelines among orthopaedic surgeons. METHODS: We sent a survey to members of the American Association of Hip and Knee Surgeons. It included five clinical vignettes based on the Kellgren-Lawrence radiographic system for classification of knee OA. Respondents selected treatment currently supported or not supported by the AAOS guidelines. RESULTS: Of 345 responses, the frequency of use of recommended interventions was 80%, 82%, 21%, 50%, and 98% for OA at stages 0 through 4, respectively. For stage 2 and stage 3 OA, intra-articularhyaluronic acid was the most commonly selected intervention not recommended by the AAOS. DISCUSSION: Apparently, AAOS guidelines on the treatment of OA have not reached the orthopaedic community, resulting in lack of treatment consensus and continued use of modalities with no proven patient benefits. CONCLUSIONS: Management of moderate to severe knee OA does not align with AAOS guidelines. We encourage researchers to conduct clinical trials to identify the role of intra-articular corticosteroids in treating this condition.
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