What is the Decision Aid for Knee Osteoarthritis?

Drs. Deborah Marshall, Jeffrey Johnson and colleagues have launched a new tool to help inform and guide patients who are unsure about knee replacement surgery. This tool is now available to all patients in Alberta and has been created to provide personalized results and comparisons for patients anxious and uncertain about deciding on knee replacement surgery or continuing with non-surgical treatment options.

Start the Decision Aid

Dr. Marshall and her colleagues at the University of Calgary, Dr. Jeff Johnson at the University of Alberta, and the Institute for Improved Health Outcomes (formerly Alberta Bone and Joint Health Institute) have developed a personalized patient support Decision Aid for people with knee osteoarthritis (OA). OA is the most common chronic progressive joint disease affecting over 15% of Canadians and is the most common reason for joint replacement surgery, called total knee arthroplasty (TKA). TKA is an effective treatment for knee OA, but demand for TKA continue to increase and waiting times are ever increasing as the population ages.

For patients considering their treatment options, Dr. Marshall and her team trialed a pilot patient decision aid in an orthopedic clinic. This tool used a quality of life survey known as the EQ-5D-5L, which is routinely captured by the clinics in the delivery of care, to populate personalized tables and graphics for patients to use when making a decision for their treatment. Patients could then consider their own situation and compare it to similar patients in the province to provide insight into likely treatment outcomes. Patients who completed the personalized decision aid were more likely to make a high-quality decision about TKA and, interestingly, were less likely to want to have surgery for their knee OA right away. This pilot trial was proof of concept of the effectiveness in enhancing decision quality for patients considering TKA.

In the years since the pilot trial, Drs. Marshall and Johnson and their team further enhanced the tool in conjunction with patient feedback and expert insight from the Institute for Improved Health Outcomes (IIHO) and their clinical partners. They developed an individualised online patient decision aid capturing benefits and harms based on comparative post-surgery outcomes from similar patients in Alberta. A key element of the decision aid was EQ-5D-5L data, routinely collected before and after TKA surgery. The new tool has been launched for use in clinical across the province starting in Fall of 2024 is now available to thousands of patients for use in their own individual decision making for their unique situation, giving them have another tool to help make an informed decision about what is best for them.

Scientific Evidence for the Decision Aid used for Knee Osteoarthritis in Alberta