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TABLE 1. CURRENT DECISION-MAKING PROCESS IN END-STAGE DEGENERATIVE ARTHRITIS OF THE KNEE

TABLE 1. CURRENT DECISION-MAKING PROCESS IN END-STAGE DEGENERATIVE ARTHRITIS OF THE KNEE.

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TABLE 1. CURRENT DECISION-MAKING PROCESS IN END-STAGE DEGENERATIVE ARTHRITIS OF THE KNEE

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  1. TABLE 1. CURRENT DECISION-MAKING PROCESS IN END-STAGE DEGENERATIVE ARTHRITIS OF THE KNEE Patient has exhausted all medical, surgical and lifestyle modification options in treating advanced degenerative arthritis of the knee and seeks discussion with orthopaedic surgeon of further options (total knee replacement). Orthopaedic surgeon does not recommend total knee arthroplasty and suggests an alternative Orthopaedic surgeon recommends total knee arthroplasty as a treatment option PATIENT CONSIDERS SURGEON’S RECOMMENDATION Patient chooses not to proceed with total knee replacement Patient chooses to proceed with total knee replacement

  2. TABLE 2. KNEE PATIENT TRIAGE ALGORITHM Additional Notes: Patients should always be offered the option of an appointment with the provider that they have seen previously. Hemophilia patients should continue to be referred to Dr. Bernini

  3. TABLE 3. EVENTS LEADING UP TO TOTAL KNEE REPLACEMENT AND THE POST-HOSPITAL COURSE Patient decides to proceed with total knee replacement Appointment is made with primary care provider (usually an internist) for medical clearance A standard battery of preoperative labs is performed including complete blood count, chem-7 profile, electrocardiogram and chest x-ray Patient admitted to DHMC, has total knee replacement and is discharged to home or to extended care facility Patient attends total knee replacement class Regularly-scheduled follow-up with orthopaedist at 6 weeks, 12 weeks, 6 months and one year. Radiographs, interval history, exam and standardized radiographs are obtained at each visit.

  4. TABLE 4. PROPOSED DECISION-MAKING PROCESS IN END-STAGE DEGENERATIVE ARTHRITIS OF THE KNEE Patient has exhausted all medical, surgical and lifestyle modification options in treating advanced degenerative arthritis of the knee and seeks discussion with orthopaedic surgeon of further options (total knee replacement). Orthopaedic surgeon does not recommend total knee arthroplasty and suggests an alternative Orthopaedic surgeon recommends total knee arthroplasty as a treatment option PATIENT CONSIDERS SURGEON’S RECOMMENDATION SHARED DECISION -MAKING AID Patient chooses not to proceed with total knee replacement Patient chooses to proceed with total knee replacement

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