Patient Preferences Regarding Surgical Interventions for Knee Osteoarthritis

Abstract

Surgical interventions for knee osteoarthritis (OA) have markedly different procedure attributes and may have dramatic differences in patient desirability. A total of 323 patients with knee OA were included in a dual response, choice-based conjoint analysis to identify the relative preference of 9 different procedure attributes. A model was also developed to simulate how patients might respond if presented with the real-world knee OA procedures, based on conservative assumptions regarding their attributes. The "amount of cutting and removal of the existing bone" required for a procedure had the highest preference score, indicating that these patients considered it the most important attribute. More specifically, a procedure that requires the least amount of bone cutting or removal would be expected to be the most preferred surgical alternative. The model also suggested that patients who are younger and report the highest pain levels and greatest functional limitations would be more likely to opt for surgical intervention.

Keywords: Arthroplasty; KineSpring; implant; orthopedics; osteotomy; unicompartmental knee unloading.

Figure 1.

Trade-off exercise step 1, “For the 3 treatments below, which one would you be most likely to have and which one would you be least likely to have?”

Figure 2.

Trade-off exercise step 2, “This is the treatment you preferred. How likely would you be to actually have that treatment?”

Figure 3.

Preference score estimates for attributes of knee osteoarthritis surgical procedures (100% scale). Attributes are sorted from highest to lowest relative importance.