Surgical Priority 1 from the Early Hip and Knee Osteoarthritis PSP

UNCERTAINTY: Taking cost into account what is the most effective treatment for early OA between surgical and non surgical treatments? (JLA PSP Surgical Priority 1)
Overall ranking amongst surgical questions	1
JLA question ID	0041/1
Extra explanatory note	Outcomes; Measures for surgical priorities should reflect changes in tissue, and patient outcomes Merits or otherwise of doing research comparing different sorts of surgery rather than comparing surgery with no surgery?
Evidence	2 x NICE Clinical Knowledge Summaries for hip and for knee (2015) neither of which address this question specifically http://cks.nice.org.uk/osteoarthritis
Health Research Classification System category	Musculoskeletal

Extra information provided by this PSP
Original uncertainty examples	I realise that the cost of the replacement joints, their life span and a surgeons time all equate to the tendency to delay needed operations that could prolong an individuals normally healthy life style. Is there any research being done into a more cost effective way of providing a suitable way of doing this. If a person remains active longer then this surely would benefit the NHS in other ways since an active individual is better than a static one. ~ Why are there financial limitations on key hole surgery for the hip when knee surgery is commonplace and works?
Submitted by	2 patient/carers, 2 clinicians, 1 carer/clinician

Extra information provided by this PSP

Original uncertainty examples

I realise that the cost of the replacement joints, their life span and a surgeons time all equate to the tendency to delay needed operations that could prolong an individuals normally healthy life style. Is there any research being done into a more cost effective way of providing a suitable way of doing this. If a person remains active longer then this surely would benefit the NHS in other ways since an active individual is better than a static one. ~ Why are there financial limitations on key hole surgery for the hip when knee surgery is commonplace and works?

Submitted by

2 patient/carers, 2 clinicians, 1 carer/clinician

PSP information
PSP unique ID	0041
PSP name	Early Hip and Knee Osteoarthritis
Total number of uncertainties identified by this PSP.	52 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	26 February 2016