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IJMDC. 2019; 3(4): 383-388

Factors that affect orthopedic surgeon's decision in the total joint replacement in hip and knee osteoarthritis: a cross-sectional study in KSA

Emran Mohammed Badgish, Abdulkader Alsayed, Marwan H. Alahmadi, Abdulwahaab M. Badghish, Ibrahim Aldobayyan, Mohammed Alsarrani.


Background: Shared decision-making requires informing patients and ensuring that treatment decisions reflect their goals. It is not clear to what extent this happens for patients considering total joint replacement (TJR) for hip or knee osteoarthritis (OA).
Methodology: This study was a cross-sectional study performed in Saudi Arabia by using validated pre-tested questionnaire; consent form was signed before data collection. To assess factors associated with the indication for TJR, univariable analyses where OR with 95% confidence intervals has been calculated were performed in each patient population, evaluating each variable. Forward multivariable logistic regressions will then be performed. Surgeons’ 109 characteristics were analyzed at the patient level rather than at the surgeon level.
Results: Regarding the knee patients, the mean age of survey respondents was 69.8 ± 12.4 years; 56.6% of patients were female; the mean body mass index (BMI) was 31.6 ± 4.8 kg/m2; the participants whose BMI > 35 kg/m² was 45 (15%); OA symptom duration was 6.9 ± 7.6 years; the mean of Western Ontario and McMaster Universities Osteoarthritis (WOMAC) subscale regarding pain, function, and stiffness was 53.7 ± 20.8, 56.4 ± 21.4, and 57.9 ± 24.4, respectively. WOMAC total score mean was 55 ± 20.2. HOOS /Knee injury and Osteoarthritis Outcome Score (KOOS) quality-of-life subscale mean was 26 ± 14.5. OARSI JSN radiographic grade was 210 (70%). Approximately all surgeons were males (92.3%) and their experience period was 16.9 ± 7.7.
Conclusion: The most important findings of the present study were older age, longer OA symptom duration, lived alone, higher WOMAC subscale score, higher OARSI JSN radiographic grade, and male gender of the surgeon, which were critical factors in deciding for both total knee replacement and total hip replacement surgeries.

Key words: Hip osteoarthritis, knee osteoarthritis, orthopedic surgeon, total joint replacement (TJR).

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