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AAOS board approve appropriate use criteria for carpal tunnel syndrome, knee OA
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The board of directors of the American Academy of Orthopaedic Surgeons have approved new appropriate use criteria for the management of carpal tunnel syndrome and the surgical management of osteoarthritis of the knee.
With 135 diagnostic scenarios, including patient-reported pain, impairment, examination and electrodiagnostic testing and outcomes, the appropriate use criteria (AUC) for management of carpal tunnel syndrome was created to assist orthopedic surgeons and other clinicians in determining if patients have carpal tunnel syndrome, as well as the optimal treatment method, according to the press release.
“Carpal tunnel is a complex diagnosis,” Robert H. Quinn, MD, appropriate use criteria section leader on the Committee on Evidence-Based Quality and Value, said in the release. “With a common condition like carpal tunnel syndrome, which has seen a significant variation in the approach, diagnosis and treatment, the AUC succinctly directs the provider toward a fairly narrow and evidence-based decision making and treatment pathway.”
The release also noted the knee osteoarthritis (OA) AUC includes 864 scenarios that consider pain, knee instability, patient age, knee alignment and extension, number of knee compartments affected and varus/valgus. The AUC for the surgical management of OA of the knee looks at total knee replacement (TKR), unicompartmental knee replacement and realignment osteotomy, as well as scenarios when each treatment method is appropriate. For the most part, the criteria lean more toward TKR in older patients, while unicompartmental surgery and realignment osteotomy for younger patients and patients with more limited OA, according to the AAOS release.
“The younger you are the longer you will have to live with the treatment, and a higher likelihood that your treatment will have to be revised,” Quinn said. “We want to preserve as much of the normal anatomy as possible for as long as possible.”
The specific diagnostic criteria provided by the new AUCs complement and build upon the clinical practice guidelines for carpal tunnel and OA of the knee, titled “Management of carpal tunnel syndrome” and “Surgical management of osteoarthritis of the knee.”
References:
www.orthoguidelines.org/go/auc/default.cfm?auc_id=224989&actionxm=Terms
www.orthoguidelines.org/go/auc/default.cfm?auc_id=224986&actionxm=Terms
http://newsroom.aaos.org/media-resources/news/carpal-tunnel-knee-osteoarthritis-orthopaedic-surgery.htm