ArticleBMC musculoskeletal disorders2015
Why we still perform arthroscopy in knee osteoarthritis: a multi-methods study.
Article in BMC musculoskeletal disorders, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 16 citations in OpenAlex.
- Arthroscopic knee debridement in osteoarthritis in the older age can be satisfactory.Journal of clinical orthopaedics and trauma · 2023Article
- A tailored intervention does not reduce low value MRI's and arthroscopies in degenerative knee disease when the secular time trend is taken into account: a difference-in-difference analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Article
- Arthroscopic Arthroplasty for Knee Osteoarthritis: Denervation of Subchondral Bone and Comprehensive Synovectomy.Arthroscopy techniques · 2021Article
- ARthroscopy in Knee OsteoArthritis (ARK-OA): a multicentre study assessing compliance to national guidelines.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2021Article
- Previous History of Knee Arthroscopy in Patients Undergoing Total Knee Arthroplasty: An Examination of the Effect of the Literature and American Academy of Orthopaedic Surgeons 2013 Arthroscopy Guidelines on Clinical Practice.Arthroscopy, sports medicine, and rehabilitation · 2021Article
- Preferences and beliefs of Dutch orthopaedic surgeons and patients reduce the implementation of "Choosing Wisely" recommendations in degenerative knee disease.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Article
- Decreasing the number of arthroscopies in knee osteoarthritis - a service evaluation of a de-implementation strategy.BMC musculoskeletal disorders · 2020Article
- Trends in the Use of Knee Arthroscopy in Adults.JAMA internal medicine · 2018Article
- Challenges and controversies of complex interventions in osteoarthritis management: recognizing inappropriate and discordant care.Rheumatology (Oxford, England) · 2018Review
- Use of theory to plan or evaluate guideline implementation among physicians: a scoping review.Implementation science : IS · 2017Article
- How does surgery compare with advanced intra-articular therapies in knee osteoarthritis: current thoughts.Therapeutic advances in musculoskeletal disease · 2016Review
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundKnee arthroscopy has historically been a common treatment for knee osteoarthritis. However, multiple Randomised Controlled Trials along with a Cochrane review has led NICE to recommend that arthroscopy is not used in the vast majority of patients that have knee osteoarthritis. These recommendations have been replicated internationally. The use of arthroscopy for knee osteoarthritis has decreased; however, it is still prevalent. This study examines the factors that are perceived to influence decision-making using a theoretical framework that was developed for behaviour change research (Theoretical Domains Framework). This study will allow future work to develop and evaluate an intervention specifically targeted to the barriers identified.
methodsA multimodal approach was used including questionnaire research and semi-structured interviews with all grades of physician offering a knee arthroscopy service in a Level One Trauma Centre in the West Midlands, U.K. Focus groups with patients were also conducted. Mixed methods analysis was used, with descriptive statistics for quantitative data, and thematic content analysis for qualitative data.
resultsA total of 26 surgeons responded to questionnaires, with 6 semi-structured interviews taking place. All surgical grades were represented. Two focus groups of six patients were performed. The results identified 13 beliefs across 12 domains (some beliefs were represented across domains). The beliefs that there was a pressure from patients to do something, that there were limited other options available, that surgeons wanted to meet patients expectations, and that there was a time pressure in clinic appeared to be the predominant barriers.
conclusionsUsing the Theoretical Domains Framework, this paper has described the relevant barriers and enablers to the implementation of NICE guidance regarding arthroscopy use in patients with knee osteoarthritis. The next step in this process is the development of a targeted intervention, and we discuss the barriers that are most likely to alter practice if targeted through an intervention, and how such an intervention could look. Such an intervention would require evaluation within the clinical setting.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.