January 2016
Blog readers will have gathered by now that I am really interested in healthcare; I like to know what my care options are; I like to have an active and informed role in making decisions that affect my health.
I am not a clinician - but in the last fifteen years I have been immersed in a lot of medical information and I have developed some skills for sorting the wheat from the chaff (apologies to those of you who are gluten free).
I thought other people might find it useful if I share some of the information I found useful when I went looking for information about options for managing osteoarthritis of the knee.
Many of the websites I am mentioning also have a wide range of other resources that readers with different health interests (such as cancer, gynaecology, diabetes or heart disease) may also be able to explore these sights and find documents of relevance to them. Just click the underlined links below to see these websites for yourself.
Decision Aids
I get quite excited about decision aids - I find them really helpful and there is a growing amount of evidence in support of their use in assisting people to make decisions based on their own individual circumstances.
I found two decision aids quite helpful in thinking about my options and forming the questions I was going to discuss with my doctors.
They were:
Gathering Information about Options
I initially wanted to look at non-surgical options (I was really hoping that I could delay surgery for some years). The website I found the most informative was a US one called Healthline. They have some really straight talking videos (I have just re-watched the knee surgery one and I now feel a bit queasy). I think these videos are better than the NZ Ministry of Health video on knee replacement - but here is a link if you want to watch it.
In addition to the videos, the Healthline website as well as some clear info about:
Once I had a summary of the main options - I then went through a search process to find the latest articles about the effectiveness of each of the options. Probably a bit more obsessive than your average person....(I have just noticed that Healthline also have an article on managing post operative pain - so will just have a quick break from blogging to read that...)
There is also some good material from NHS Choices in the UK which is clear and concise about the options and risks etc.
Along with the information about the surgical and non-surgical options, I also downloaded the most recent reports from the Joint Replacement registries in Australia and New Zealand. The 2015 Australian report for Lay readers talks about the current issues associated with knee replacement (I thought this was quite interesting).However, I thought the NZ report was even better - eg there are 48 different types of knee prosthesis types walking around in NZ, people as young as 8 years of age and as old as 100 years of age have had knee replacements. Around 7,000 knee replacements are performed in NZ each year and most surgeons perform around 33 procedures each per year.
The report also provides reports on patient based outcome measures. In NZ the Oxford Knee Score is used and can be completed online at the NZ Orthopaedic Association website. I have completed this survey and printed it out and I plan to compare my preoperative data with my post operative outcomes in a few months.
I have also signed up to a couple of websites:
Good luck - I hope you find some information that informs you when you use these websites.
Blog readers will have gathered by now that I am really interested in healthcare; I like to know what my care options are; I like to have an active and informed role in making decisions that affect my health.
I am not a clinician - but in the last fifteen years I have been immersed in a lot of medical information and I have developed some skills for sorting the wheat from the chaff (apologies to those of you who are gluten free).
I thought other people might find it useful if I share some of the information I found useful when I went looking for information about options for managing osteoarthritis of the knee.
Many of the websites I am mentioning also have a wide range of other resources that readers with different health interests (such as cancer, gynaecology, diabetes or heart disease) may also be able to explore these sights and find documents of relevance to them. Just click the underlined links below to see these websites for yourself.
Decision Aids
I get quite excited about decision aids - I find them really helpful and there is a growing amount of evidence in support of their use in assisting people to make decisions based on their own individual circumstances.
I found two decision aids quite helpful in thinking about my options and forming the questions I was going to discuss with my doctors.
They were:
- The Cochrane Musculoskeletal decision aid - What are my options for managing hip or knee osteoarthritis? I like the way it quite frank and upfront about the serious harms and side effects.
- The other decision aid I used was from Alberta Canada - Arthritis: Should I have knee replacement surgery? I like the way this decision aid provides a little quiz towards the end to help you clarify the points of importance to you.
Gathering Information about Options
I initially wanted to look at non-surgical options (I was really hoping that I could delay surgery for some years). The website I found the most informative was a US one called Healthline. They have some really straight talking videos (I have just re-watched the knee surgery one and I now feel a bit queasy). I think these videos are better than the NZ Ministry of Health video on knee replacement - but here is a link if you want to watch it.
In addition to the videos, the Healthline website as well as some clear info about:
- risks and complications of surgery
- alternatives to surgery, and
- clinical outcomes.
Once I had a summary of the main options - I then went through a search process to find the latest articles about the effectiveness of each of the options. Probably a bit more obsessive than your average person....(I have just noticed that Healthline also have an article on managing post operative pain - so will just have a quick break from blogging to read that...)
There is also some good material from NHS Choices in the UK which is clear and concise about the options and risks etc.
Along with the information about the surgical and non-surgical options, I also downloaded the most recent reports from the Joint Replacement registries in Australia and New Zealand. The 2015 Australian report for Lay readers talks about the current issues associated with knee replacement (I thought this was quite interesting).However, I thought the NZ report was even better - eg there are 48 different types of knee prosthesis types walking around in NZ, people as young as 8 years of age and as old as 100 years of age have had knee replacements. Around 7,000 knee replacements are performed in NZ each year and most surgeons perform around 33 procedures each per year.
The report also provides reports on patient based outcome measures. In NZ the Oxford Knee Score is used and can be completed online at the NZ Orthopaedic Association website. I have completed this survey and printed it out and I plan to compare my preoperative data with my post operative outcomes in a few months.
I have also signed up to a couple of websites:
- the musculoskeletal elf - an evidence-based website that reports on the latest findings from systematic reviews such as exercises
- the US based Arthritis Foundation - they have some useful tips on physical exercise - but are rather prone to ask for donations
- Option Grid - they have either an interactive or static range of decision aids - including some on OA of the knee
- HealthTalk is a nice UK based website that has videos and audio clips of people talking about how they manage their health conditions - and this is accompanied by written evidence-based health advice
Good luck - I hope you find some information that informs you when you use these websites.
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