Instruments to assess appropriateness of hip and knee arthroplasty: a systematic review
Authors' conclusion
Most instruments included traditional criteria for assessing JA appropriateness but did not include a trial of conservative treatments or shared decision-making elements. There was limited evidence on psychometric properties.
Study context
- Population
- Instruments for assessing appropriateness of elective joint arthroplasty (JA) for adults with primary hip and knee osteoarthritis (OA)
- Participants
- 55 instruments
- Comparison
- Instruments compared with Hawker et al. JA consensus criteria
- Outcome
- Criteria and psychometric properties of JA appropriateness instruments
Methodological detailsCochrane methods, PRISMA guidelines, five databases, two independent reviewers, Fitzpatrick's and COSMIN approaches
- Cochrane methods
- PRISMA guidelines
- Five databases
- Two independent reviewers
- Fitzpatrick's and COSMIN approaches
Pooled result
As reported in the abstract
Hawker et al. JA consensus criteria met by instruments
- Instruments meeting all Hawker et al. criteria
- 0
- Pain
- n = 50
- Function
- n = 49
- Quality of life
- n = 33
- Radiography
- n = 24
- Clinical evidence of OA
- n = 18
- Expectations
- n = 15
- Readiness for surgery
- n = 11
- Conservative treatments
- n = 8
- Patient/surgeon agree benefits outweigh risks
- n = 0
- Most criteria met: instrument by Arden et al.
- 6 of 9
Further pooled results
Psychometric properties tested
- Appropriateness
- n = 55
- Face/content validity
- n = 55
- Predictive validity
- n = 29
- Construct validity and feasibility
- n = 24
- Inter-rater reliability
- n = 13
- Internal consistency
- n = 5
- Intra-rater reliability
- n = 3
- Most psychometric properties met: Gutacker et al. and Osborne et al.
- 4 of 10
Original publication
Instruments to assess appropriateness of hip and knee arthroplasty: a systematic review. Osteoarthritis Cartilage. Published 9 March 2023. doi:10.
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