The MARKA Study: is surgery the best solution for osteoarthritis of the knee?

The MARKA Study brings together a team of leading experts in clinical and health services and health economics to understand how patients and doctors balance the benefits and risks of surgery to treat end-stage osteoarthritis of the knee.

The Maximum Acceptable Risk of Complication in Total Knee Arthroplasty (MARKA) Study

The MARKA Study brings together a team of leading experts in clinical and health services and health economics to understand how patients and doctors balance the benefits and risks of surgery to treat end-stage osteoarthritis of the knee.

Osteoarthritis is a disabling disease, impacting the lives of 43 million people worldwide, more than half of whom are aged 60 or older.  Total knee arthroplasty, or a knee replacement, is the mainstay treatment for people with end-stage osteoarthritis of the knee. However, there is evidence that the procedure is being overused, leading to waste and inefficiency in the healthcare system, and exposing patients to unnecessary risk.

Funded by the National Health and Medical Research Council, the research team, which includes Melbourne Institute health economists Professor Anthony Scott and Dr Jinhu Li, is using discrete choice experiments (DCE) to examine and compare patient and surgeon preferences and trade-offs when it comes to the risk of complications and improvements in pain and disability.

In a unique randomised control trial, researchers are also using DCEs as an intervention, providing information to patients in an attempt to reduce often unrealistic expectations about the outcome of knee replacement surgery, thereby improving their overall satisfaction with the outcome.

Impact

Understanding how patients and clinicians balance the benefits and risks of undergoing total knee arthroplasty is critical for improving patient satisfaction and reducing the burden of poor outcomes, requiring ongoing care, on the national health system.

Output

Michelle M Dowsey, Anthony Scott, Elizabeth A. Nelson, Jinhu Li, Vijaya Sundararajan, Mandana Nikpour and Peter F. M. Choong, 'Using discrete choice experiments as a decision aid in total knee arthroplasty: study protocol for a randomised controlled trial', Trials, August 2016

Investigators