Is Magnetic Resonance Imaging Overused Among Patients Undergoing Total Knee Arthroplasty?

Autor: Mukkamala L; From the Shiley Center for Orthopaedic Research and Education at Scripps Clinic, La Jolla, CA (Ms. Mukkamala and Ms. Schaffer), and the Department of Orthopaedic Surgery, Scripps Clinic, La Jolla, CA (Dr. Weber, Dr. Wilde, and Dr. Rosen)., Schaffer SL, Weber MG, Wilde JM, Rosen AS
Jazyk: angličtina
Zdroj: Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews [J Am Acad Orthop Surg Glob Res Rev] 2024 Oct 21; Vol. 8 (10). Date of Electronic Publication: 2024 Oct 21 (Print Publication: 2024).
DOI: e24.00258
Abstrakt: Introduction: With increasing healthcare costs, it is important to quantify the number of total knee arthroplasty (TKA) patients who have MRIs that are not considered clinically necessary. The purpose of this study was to determine the number of unnecessary preconsultation MRIs done among TKA patients at our institution.
Methods: Eight hundred and sixty-nine patients who underwent a primary TKA were identified. Review of medical records and imaging results was conducted to determine which patients had received preconsult MRIs and whether they were necessary or unnecessary.
Results: Of the 869 TKA, 177 (20.4%) presented with a preconsultation MRI, of which, 112 met the study inclusion criteria. Of the 112 MRIs, 18 (20.7%) were done without radiographic imaging, and 69 (79.3%) were completed after radiographically evident moderate-to-severe arthritis. Overall, 87 MRIs (10.0%) were deemed clinically unnecessary.
Conclusions: Referring physicians are overusing MRIs before consultation with an orthopaedic surgeon. The 87 patients who had unnecessary MRIs at our institution over a one-year period represented a cost of $20,706. Extrapolating that number to the scale of patients affected by arthritis each year is potentially a staggering amount of money. Evidence-based guidelines should be put into place to optimize healthcare utilization.
(Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.)
Databáze: MEDLINE