Current Practice Trends in Knee Arthroplasty in India Among ISHKS Members: ISHKS Annual Meeting 2019

Abstract

Aim: To assess the current practice trends in knee arthroplasty in India among ISHKS members.

Methods: Literature review on 12 areas of key interest in total knee arthroplasty was conducted. Twenty-eight questions pertaining to these key areas in total knee arthroplasty surgery were presented to the delegates for a physical voting with audience response system (ARS) at ISHKS meeting, Bangalore, 2019. The members who could not attend the meeting voted by an online monkey survey. All questions were given three responses: a. Agree, b. Disagree, and c. Abstain.

Results: 310 delegates participated and 295 voted in the physical meeting and 110 voted online. Consensus was reached for 28 statements representing five domains on the best practices. Overall, 92% of statements reached unanimous or strong consensus. The statements that achieved strong majority (> 90%) were the factors on pre-operative skin preparations, administration of antibiotics 30 min prior skin incision, and current practices of bilateral TKR. Furthermore, there was strong consensus approval on the role of aspirin for prophylaxis of DVT, lack of benefit on use of drain, considerations for pre-emptive analgesia, and neuraxial anesthesia. Finally, there were disparate views and weak consensus on use of laminar airflow theaters and use of surgical space suits, length of antibiotic administration postoperatively, and linking of DVT with PE and death.

Conclusion: This study gives the surgeon practice preferences in knee arthroplasty in India and assists in clinical decision-making for all healthcare professionals.

Keywords: Best clinical practices; Consensus; Knee arthroplasty; Practice guidelines; Practice trends; Total knee replacement.

Fig. 1

Flow chart showing study methodology