Surgeon age as the major factor in recommendation of uni-compartmental knee replacement versus high tibial osteotomy: a case study in orthopaedic decision making

This case report concerns surgical decision making. The subject is a 59 year old male orthopaedic surgeon with medial compartment knee arthritis. Both high tibial valgus osteotomy and uni-compartmental knee replacement would be appropriate with similar outcomes reported in the literature. Surprising...

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Bibliographic Details
Published in:The Iowa orthopaedic journal 2012, Vol.32, p.22-27
Main Authors: Dietz, Frederick R, Kelman, Mark G
Format: Article
Language:English
Subjects:
Age Factors
Arthroplasty, Replacement, Knee - psychology
Clinical Competence
Decision Making
Humans
Knee Joint - diagnostic imaging
Knee Joint - surgery
Original
Osteoarthritis, Knee - diagnostic imaging
Osteoarthritis, Knee - surgery
Osteotomy - psychology
Radiography
Treatment Outcome
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Summary:This case report concerns surgical decision making. The subject is a 59 year old male orthopaedic surgeon with medial compartment knee arthritis. Both high tibial valgus osteotomy and uni-compartmental knee replacement would be appropriate with similar outcomes reported in the literature. Surprisingly, almost all young surgeons recommended a uni-compartmental knee replacement and almost all older surgeons recommended a high tibial osteotomy. We discuss the reasons that surgeon age, which is clearly irrelevant to the optimal decision, is the dominant determinant of surgical recommendation for this patient.
ISSN:1541-5457
1555-1377