Do orthopedic surgeons agree on the criteria for deciding to operate?
Although all agree that the severity of pain, limitation of movement, and radiographic appearance are the three major factors, there is no agreement on the exact degree of change that triggers the need for surgery; this is largely because standard ways of measuring these factors are not generally accepted. Perhaps more importantly, there is no good information on patients’ own judgment as to which of them is most important. It is certainly not easy measure pain and function in units that are meaningful to patients, but several test batteries have been used. One of these is the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index, which is widely used to measure the degree of pain, stiffness and function in knee and hip OA. In time, tests such as these will make it easier for the patient to better understand what can be expected from surgery in terms of reduced pain, impaired function, and so on. At present there are only a few official guidelines on TKR surgery availa
