WHICH SHOULD BE PRIORITISED: KNEE SURGERY OR SPINE SURGERY? A RETROSPECTIVE STUDY ON TREATMENT PROTOCOLS FOR PATIENTS WITH COEXISTING PATHOLOGIES.

Nilesh Kumar  Agrawal; Kumar  Rahul; Anant  Akash; Santosh  Kumar

doi:10.51168/sjhrafrica.v5i12.1506

Authors

Nilesh Kumar Agrawal Senior Resident, Department of Orthopaedics, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
Kumar Rahul Senior Resident, Department of Orthopaedics, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
Anant Akash Senior Resident, Department of Orthopaedics, Indira Gandhi Institute of Medical Sciences,
Santosh Kumar Professor and Head, Department of Orthopaedics, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India

DOI:

https://doi.org/10.51168/sjhrafrica.v5i12.1506

Keywords:

Knee Surgery, Spine Surgery, Treatment Order, Degenerative Disorders, Surgeons' Preferences

Abstract

Background

The increasing prevalence of concurrent degenerative knee and lumbar spine disorders presents a challenge for surgical intervention, as the optimal order of treatment remains unclear. This study aims to investigate the influence of knee deformity on surgeons' preferences for treatment orders, contributing to informed decision-making in managing these complex cases.

Methods

This retrospective study, conducted over one year at the Indira Gandhi Institute of Medical Sciences (IGIMS) in Patna, involved 50 patients with low back pain and radiculopathy. Participants underwent comprehensive assessments based on predefined inclusion and exclusion criteria, followed by caudal epidural steroid injections.

Results

Responses were obtained from 25 knee arthroplasty and 25 spine surgeons, achieving response rates of 50% for each specialty. The median clinical experience post-training was 26 years for both groups. Recommendations for "TKA first" varied significantly among knee arthroplasty surgeons, with rates of 32%, 76%, 60%, 8%, and 80% across five scenarios (P < 0.001). In comparison, spine surgeons recommended "spine surgery first" at rates of 24%, 80%, 52%, 16%, and 76%, also showing significant differences (P < 0.001). Most spine surgeons indicated their decision would remain unchanged if the procedure was a decompression.

Conclusion

This study emphasizes the significant influence of knee deformity on treatment order preferences among knee arthroplasty and spine surgeons, highlighting the need for individualized decision-making in managing patients with concurrent degenerative knee and lumbar spine disorders.

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