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NIH Consensus Statement on Total Knee Replacement December 8-10, 2003*

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The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
NIH Consensus Panel:
E. Anthony Rankin, M.D.
Chief, Orthopedic Surgery
Providence Hospital
1160 Varnum St. N.E.
Suite 112
Washington D.C. 20017
Graciela S. Alarcòn, M.D., M.P.H.
Professor of Medicine
University of Alabama at Birmingham
Faculty Office Towers
Room 832
510 20th Street South
Birmingham, AL 35294-3408
Rowland W. Chang, M.D., M.P.H.
Professor of Preventive Medicine, Physical Medicine,
and Rehabilitation
Department of Preventive Medicine
Northwestern University Medical School
680 North Lake Shore Drive
Suite 1102
Chicago, IL 60611
Leo M. Cooney, Jr., M.D.
Chief, Section of Geriatric Medicine
Yale-New Haven Hospital
Tompkins 17
20 York Street
New Haven, CT 06504
Linda S. Costley
P.O. Box 1275
Covington, GA 30015
Anthony Delitto, Ph.D., P.T.
Associate Professor and Chair
Department of Physical Therapy
School of Health and Rehabilitation Sciences
University of Pittsburgh
6035 Forbes Tower
Pittsburgh, PA 15260
Richard A. Deyo, M.D., M.P.H.
Professor of Medicine and Health Services
University of Washington School of Medicine
1959 Northeast Pacific Street,
Campus Box 357183
Seattle, WA 98195-7183
Sue K. Donaldson, Ph.D., R.N., FAAN
Professor of Medicine, School of Medicine
Professor of Nursing, School of Nursing
Johns Hopkins University
Anne M. Pinkard Building, Room 446
525 North Wolfe Street
Baltimore, MD 21205-2110
Marc C. Hochberg, M.D., M.P.H.
Head, Division of Rheumatology
University of Maryland School of Medicine
Medical School Teaching Facility, Room 834
10 South Pine Street
Baltimore, MD 21201
Catherine H. MacLean, M.D., Ph.D.
Professor, Division of Rheumatology and Arthritis
School of Medicine
University of California, Los Angeles
32-51 Rehabilitation Center, Box 951670
Los Angeles, CA 90095-1670
Edward H. Yelin, Ph.D.
Professor of Medicine and Health Policy
School of Medicine
University of California, San Francisco
UCSF Box 0920
San Francisco, CA 94143-0920
Corresponding Author:
Kelli Marciel
NIH Office of Medical Applications of Research
6100 Executive Blvd., Room 2B03
MSC 7523
Bethesda, MD 20892
E-mail: marcielk@od.nih.gov
Phone: (301) 496-4819, Fax: (301) 480-7660
NIH consensus and state-of-the-science statements are prepared by independent panels of health professionals and public representatives on the basis of (1) the results of a systematic literature review prepared under contract with the Agency for Healthcare Research and Quality (AHRQ), (2) presentations by investigators working in areas relevant to the conference questions during a 2-day public session, (3) questions and statements from conference attendees during open discussion periods that are part of the public session, and (4) closed deliberations by the panel during the remainder of the second day and morning of the third. This statement is an independent report of the panel and is not a policy statement of the NIH or the Federal Government.
The statement reflects the panel's assessment of medical knowledge available at the time the statement was written. Thus, it provides a "snapshot in time" of the state of knowledge on the conference topic. When reading the statement, keep in mind that new knowledge is inevitably accumulating through medical research.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2004 Jun 01;86(6):1328-1335
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case


Based on existing research evidence, total knee replacement (TKR) is a safe and cost-effective treatment for alleviating pain and restoring physical function in patients who do not respond to nonsurgical therapies. There are few contraindications to this surgery as it is currently used. Overall, TKR has been shown to be a very successful, relatively low-risk therapy despite variations in patient health status and characteristics, type of prosthesis implanted, orthopaedic surgeons, and surgical facilities. Improvements can be made in overall success of TKR by addressing each of these areas of variation through further research. Each year, approximately 300,000 TKR surgeries are performed in the United States for end-stage arthritis of the knee joint. As the number of TKR surgeries performed each year increases and the indications for TKR extend to younger as well as older patients, a review of available scientific information is necessary to enhance clinical decision-making and stimulate further research.
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