- Only 50.2% of visits to orthopedists for nonoperative treatment of knee osteoarthritis (KOA) adhere to the clinical practice guideline (CPG) recommendations of the American Academy of Orthopedic Surgeons (AAOS).
Why this matters
- Guideline adherence promotes patient health and saves money by avoiding unsupported or inconclusive treatments.
- Retrospective cohort of 1096 consecutive ambulatory visits to orthopedists with KOA as primary diagnosis.
- Adherence is defined by a strong recommendation of support by the AAOS; lack of adherence is defined by inconclusive or unsupported treatments.
- Severity of patients defined by Kellgren-Lawrence grades I-IV, with IV being the worst.
- Funding: None disclosed.
- Total number of interventions, 1955.
- Adherence to AAOS CPGs varies by type of patient:
- 50.2% of total interventions;
- 65% of interventions for new visit/never treated patients;
- 60% of interventions for new visit/previously treated patients; and
- 40% of interventions for return patients.
- Adherence decreases as severity increases:
- 61% of interventions for Kellgren-Lawrence grade I;
- 60% of interventions for Kellgren-Lawrence grade II;
- 54% of interventions for Kellgren-Lawrence grade III; and
- 49% of interventions for Kellgren-Lawrence grade IV.
- Annual costs (estimated) associated with any type of AAOS recommendation (ranging from "strong" to "not recommended") was $2,403,543.18, of which $1,206,757.80 (50.2%) was associated with a strong recommendation.
- Single-center study.