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Non-Arthroplasty Treatment of Osteoarthritis of the Knee

Sanders, James O. MD; Murray, Jayson MA; Gross, Leeaht MPH

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: April 2014 - Volume 22 - Issue 4 - p 256–260
doi: 10.5435/JAAOS-22-04-256
AAOS Appropriate Use Criteria Summary

The American Academy of Orthopaedic Surgeons has developed an Appropriate Use Criteria (AUC) on the Non-Arthroplasty Treatment of Osteoarthritis of the Knee (OAK). Evidence-based information, in conjunction with clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The OAK AUC clinical scenarios were derived from patient indications that generally accompany OAK as well as from the current evidence-based clinical practice guidelines and its supporting literature. The 576 patient scenarios and 10 treatments were developed by the Writing Panel, a group of clinicians who are specialists in this AUC topic. Next, the Review Panel, a separate group of volunteer physicians, independently reviewed these materials to ensure that they were representative of patient scenarios clinicians are likely to encounter in daily practice. Finally, the multidisciplinary Voting Panel (made up of specialists and nonspecialists) rated the appropriateness of treatment of each patient scenario using a 9-point scale to designate a treatment as Appropriate (median rating, 7 to 9), May Be Appropriate (median rating, 4 to 6), or Rarely Appropriate (median rating, 1 to 3). The final appropriateness ratings assigned by the voting panel can be accessed online via the AAOS OAK AUC web-based mobile application at:

From the Department of Orthopaedics, University of Rochester, Rochester, NY (Dr. Sanders), and the American Academy of Orthopaedic Surgeons, Rosemont, IL (Mr. Murray and Ms. Gross).

Dr. Sanders or an immediate family member has stock or stock options held in Abbott, AbbVie, GE Healthcare, and Hospira, and serves as a board member, owner, officer, or committee member of the American Academy of Orthopaedic Surgeons, the Pediatric Orthopaedic Society of North America, and the Scoliosis Research Society. Neither of the following authors nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Mr. Murray and Ms. Gross.

These appropriate use criteria were approved by the American Academy of Orthopaedic Surgeons on December 6, 2013.

The complete Appropriate Use Criteria for Non-Arthroplasty Treatment of Osteoarthritis of the Knee includes all tables, figures, and appendices, and is available at The OAK AUC content is also available in a web-based mobile app and can be accessed at the following address:

Non-Arthroplasty Treatment of Osteoarthritis of the Knee AUC Writing Panel: David F. Dalury, MD, Craig J. Della Valle, MD, Mark I. Ellen, MD, Eric P. Gall, MD, MACP, MACR, Brian J. McGrory, MD, Jennifer Stevens-Lapsley, PT, PhD, and AJ Yates, Jr, MD. Review Panel: Miguel A. Ayerza, MD, PhD, Santiago de Solo, MD, Robin Dore, MD, G. Kelley Fitzgerald, PT, PhD, FAPTA, E. Robert Harris, MD, Richard Haynes, MD, William M. Jones, MD, Jeffrey Katz, MD, Kent Kwoh, MD, Amanda Nelson, MD, Lee Rosenzweig, PT, DPT, CHT, James A. Shaw, MD, Jasvinder Singh, MD, Mark Spangehl, MD, Audrey Tsao, MD, and Joseph Zeni, PT, PhD. Voting Panel: Joel Block, MD, Pablo Castaneda, MD, Dennis Chin, MD, T. Derek V. Cooke, MA, MB, BChir, FRCS(C), Charles M. Davis III, MD, PhD, Yvonne Golightly, PT, MS, PhD, T. David Hayes, MD, Kenneth Jaffe, MD, Nancy E. Lane, MD, Brian McCardel, MD, Arvind D. Nana, MD, MBA, Harold W. Rees, MD, Peter F. Sharkey, MD, Terence W. Starz, MD, Kimberly Templeton, MD, and Kevin R. Vincent, MD, PhD. Moderators: James O. Sanders, MD, and Michael Heggeness, MD. AAOS Staff: Deborah S. Cummins, PhD, Jayson Murray, MA, Ryan Pezold, MA, Patrick Donnelly, MA, Anne Woznica, MLS, Leeaht Gross, MPH, and Yasseline Martinez.

© 2014 by American Academy of Orthopaedic Surgeons
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