Measuring knee arthroplasty outcomes

摘要

Outcome measures are increasingly used by clinicians, healthcare providers and implant manufacturers for a variety of reasons. Clinical outcome studies have traditionally been used but the level of evidence presented has been variable. In recent decades joint registries have provided useful data on implant survival, but implant revision as an outcome measure has restrictions as many factors contribute to it. Patient reported outcome scores have been introduced more recently and provide important information about health gain after surgical intervention. In response to guidelines from the National Institute for Clinical Excellence, the Orthopaedic Data Evaluation Panel assesses and rates implants, and Beyond Compliance advises implant manufacturers of the level of risk of newly introduced or modified prostheses. The analysis of results has become an essential part of orthopaedic practice. Outcome scores can be used to assess the effect of a disease or condition, the effect of disease treatment and its cost effectiveness of treatments. They can also be used for research purposes, teaching and peer comparison. Outcome analysis allows surgeons to make informed choices of the use of prostheses and surgical techniques based on evidence. There is increasing pressure on hospital trusts to assess their performance data and in the future clinical commissioning may depend on outcome scores for implants and treatments. Surgeons' mortality rates are openly published and available to see by the general population. Transparency is increasingly important.