A Model to Reduce The Proportion of Inappropriate Referrals to Surgery for Patients With Osteoarthritis: A Pilot Study

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https://ir.lib.uwo.ca/etd/1507; https://ir.lib.uwo.ca/cgi/viewcontent.cgi?article=2978&context=etd
Churchill, Laura K
osteoarthritis; total knee replacement; referral; predictors; surgical consult; Orthopedics
article description
A significant proportion of patients referred for total knee arthroplasty are inappropriate candidates for surgery, which warrants remediation of the referral process to reduce wait times for the initial consult. We conducted a prospective feasibility investigation involving 166 patients referred from their general practitioner for a consultation with an orthopaedic surgeon at a joint replacement clinic. The aim of this study was to improve the validity of data collection forms and to improve the feasibility of collecting data in a clinical setting. We also wanted to strengthen our estimate of the sample size to inform the timeline. We were able to optimize patient recruitment strategy, refine data collection forms to improve their validity, and determined an adjusted sample size of 887 patients, based on our finding that 43% of patients were not suitable or willing surgical candidates. The planned large cohort study is feasible within 10 months.