The American Academy of Orthopaedic Surgeons Evidence-Based Clinical Practice Guideline on Surgical Management of Osteoarthritis of the Knee

This article was updated on May 4, 2016, because of a previous error. On page 689, under the “DELAY TKA” heading, the text had previously read “Moderate evidence supports that a 5-month delay to total knee arthroplasty (TKA) does not worsen outcomes.” The text now reads “Moderate evidence supports that an 8-month delay to total knee arthroplasty (TKA) does not worsen outcomes.” An erratum has been published: J Bone Joint Surg Am. 2016 June 15;98(12):e53. The AAOS Evidence-Based Guideline on Surgical Management of Osteoarthritis of the Knee includes both diagnosis and treatment. This clinical practice guideline has been endorsed by the Arthroscopy Association of North America (AANA) and the Society of Military Orthopaedic Surgeons (SOMOS). This brief summary of the AAOS Clinical Practice Guideline contains a list of the recommendations and the rating of strength based on the quality of the supporting evidence. Discussion of how each recommendation was developed and the complete evidence report are contained in the full guideline at http://www.aaos.org/Quality/Clinical\_Practice\_Guidelines/Clinical\_Practice\_Guidelines/. ### BMI AS A RISK FACTOR Strong evidence supports that obese patients have less improvement in outcomes with total knee arthroplasty (TKA). Strength of Recommendation: Strong ★★★★ ### DIABETES AS A RISK FACTOR Moderate evidence supports that patients with diabetes are at higher risk for complications with total knee arthroplasty (TKA). Strength of Recommendation: Moderate ★★★☆ ### CHRONIC PAIN AS A RISK FACTOR Moderate evidence supports that patients with select chronic pain conditions have less improvement in patient reported outcomes with TKA. Strength of Recommendation: Moderate ★★★☆ ### DEPRESSION/ANXIETY AS A RISK FACTOR Limited evidence supports that patients with depression and/or anxiety symptoms have less improvement in patient reported outcomes with total knee arthroplasty (TKA). Strength of Recommendation: Limited ★★☆☆ ### CIRRHOSIS/HEPATITIS C AS A RISK FACTOR Limited evidence supports that patients with cirrhosis …