Summary
Objective
To assess criteria and psychometric properties of instruments for assessing appropriateness
of elective joint arthroplasty (JA) for adults with primary hip and knee osteoarthritis
(OA).
Methods
A systematic review guided by Cochrane methods and PRISMA guidelines. Studies were
searched in five databases. Eligible articles include all study designs developing,
testing, and/or using an instrument to assess JA appropriateness. Two independent
reviewers screened and extracted data. Instruments were compared with Hawker et al. JA consensus criteria. Psychometric properties of instruments were described and
appraised guided by Fitzpatrick's and COSMIN approaches.
Results
Of 55 instruments included, none met all Hawker et al. JA consensus criteria. Criteria the most met were pain (n = 50), function (n = 49), quality of life (n = 33), and radiography (n = 24). Criteria the least met were clinical evidence of OA (n = 18), expectations (n = 15), readiness for surgery (n = 11), conservative treatments (n = 8), and patient/surgeon agree benefits outweigh risks (n = 0). Instrument by Arden et al. met the most criteria (6 of 9). The most tested psychometric properties were appropriateness
(n = 55), face/content validity (n = 55), predictive validity (n = 29), construct validity and feasibility (n = 24). The least tested psychometric properties were intra-rater reliability (n = 3), internal consistency (n = 5), and inter-rater reliability (n = 13). Instruments by Gutacker et al. and Osborne et al. met the most psychometric properties (4 of 10).
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.
Keywords
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Article info
Publication history
Published online: March 08, 2023
Accepted:
February 3,
2023
Received:
September 19,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
