Total Knee Replacment. Evidence Report/Technology Assessment Number 86

摘要

The projected growth in the population with arthritis is likely to expand the future demand for elective arthroplasty. At present, there is no strong empirical base for the indicators in current use for what criteria should be used to identify potential candidates for Total Knee Arthroplasty (TKA); nor is there professional consensus around such indications. An NIH consensus conference has been planned to address these questions. This report summarizes the literature as part of the background for that conference. The objectives of the report are: (1) What are the current indications for, and outcomes from, primary total knee replacement; (2) How do specific characteristics of the patient, material and design of the prosthesis and surgical factors, affect the short-term and long-term outcomes of primary total knee replacement; (3) Are there important preoperative interventions that influence outcomes; (4) What are the indications, approaches, and outcomes for revision total knee replacement; (5) What factors explain disparities in the utilization of total knee replacement in different populations; (6) What are the directions for future research.