A Team Based Approach is Essential to Optimize Total Knee Arthroplasty Outcomes

Abstract

Total Knee Arthroplasty (TKA) is the number one, most commonly performed orthopedic operation and remains a reliable, reproducible and cost-effective surgical procedure [1]. There is a high rate of overall patient satisfaction for TKA with a subsequent high demand that continues to rise [1]. Worldwide the average rate of annual Total Knee Arthroplasty (TKA) procedures performed has doubled between 2000 and 2016 [1]. There were approximately 100,000 TKAs respectively performed in the United Kingdom (UK) in 2018 [2]. There were 155,000 Total Knee Arthroplasty’s (TKA) performed in the United States of America (USA) in 2018 with demand projected to increase to reach 1.26 million annual procedures by 2030 in the USA, alone [3,4]. Despite the popularity of this procedure, the average functional improvements following Total Knee Arthroplasty (TKA) are more modest than outcomes after Total Hip Arthroplasty (THA) [1]. The average gain in quality adjusted life years (QALYs) was 3.3 years and 4.3 years for TKA and THA, respectively [1]. These findings may be due to the longer recovery period for Total Knee Arthroplasty (TKA) compared to hip replacements, however it is evident that there may be a role for peri-operative rehabilitation to optimize these outcomes [1].