Abstract：
BACKGROUND: Informed by the precedent of an American Association of Hip and Knee Surgeons (AAHKS) survey, where 95% of participants reported instigating modifications to preoperative risk factors, this study appraised the approach of Chinese arthroplasty surgeons toward patients who had modifiable risks.
METHODS: An adaptation of the AAHKS survey tool for a Chinese cohort was undertaken. The survey queried 600 Chinese Society of Hip and Knee Surgeons members on whether the perception of unoptimized medical comorbidities and socioeconomic elements affects the propensity to offer surgical procedures.
RESULTS: Out of the distributed surveys, 150 responses were received, culminating in a response rate of 25%. The data illustrate that 98.7% of Chinese surgeons practice restrictions on arthroplasty access for patients who have modifiable risk factors, with notable frequencies for malnutrition (93.3%), anemia (91.3%), recent hyaluronic acid injections (within one month, 88.7%), and corticosteroid injections (within 3 months, 74.7%). Assessment criteria ahead of surgery included limitations such as a body mass index under 40 (47.3%), requirements for smoking cessation (57.3%), an acceptable hemoglobin A1c level (95.3%), and a dependent fasting blood glucose level (88%). Moreover, 87.3% of respondents endorsed the need for additional interventions for certain socioeconomically disadvantaged patients to achieve successful outcomes. A majority of respondents (94.7%) believed that more equitable access to care, facilitated by better-adjusted payment methodologies, could enhance patient outcomes. Current payment schemes were also perceived by a majority to potentially compromise outcomes for patients who have inadequate social support (80.7%), low socioeconomic status (67.3%), and those lacking insurance (72.7%).
CONCLUSIONS: The consistency of the almost 99% response rate in addressing modifiable risk factors prior to arthroplasty aligns closely with the reported practices in the AAHKS survey. These findings underscore the shared valuation of preoperative risk factor optimization by Chinese and American arthroplasty surgeons, notwithstanding divergent healthcare system structures.
METHODS: An adaptation of the AAHKS survey tool for a Chinese cohort was undertaken. The survey queried 600 Chinese Society of Hip and Knee Surgeons members on whether the perception of unoptimized medical comorbidities and socioeconomic elements affects the propensity to offer surgical procedures.
RESULTS: Out of the distributed surveys, 150 responses were received, culminating in a response rate of 25%. The data illustrate that 98.7% of Chinese surgeons practice restrictions on arthroplasty access for patients who have modifiable risk factors, with notable frequencies for malnutrition (93.3%), anemia (91.3%), recent hyaluronic acid injections (within one month, 88.7%), and corticosteroid injections (within 3 months, 74.7%). Assessment criteria ahead of surgery included limitations such as a body mass index under 40 (47.3%), requirements for smoking cessation (57.3%), an acceptable hemoglobin A1c level (95.3%), and a dependent fasting blood glucose level (88%). Moreover, 87.3% of respondents endorsed the need for additional interventions for certain socioeconomically disadvantaged patients to achieve successful outcomes. A majority of respondents (94.7%) believed that more equitable access to care, facilitated by better-adjusted payment methodologies, could enhance patient outcomes. Current payment schemes were also perceived by a majority to potentially compromise outcomes for patients who have inadequate social support (80.7%), low socioeconomic status (67.3%), and those lacking insurance (72.7%).
CONCLUSIONS: The consistency of the almost 99% response rate in addressing modifiable risk factors prior to arthroplasty aligns closely with the reported practices in the AAHKS survey. These findings underscore the shared valuation of preoperative risk factor optimization by Chinese and American arthroplasty surgeons, notwithstanding divergent healthcare system structures.
摘要：
背景：根据美国髋关节和膝关节外科医生协会（AAHKS）调查的先例，其中95％的参与者报告了对术前危险因素的修改，这项研究告知了中国人关节成形术外科医生对具有可改变风险的患者的治疗方法.
方法：对中国队列的AAHKS调查工具进行了调整。该调查询问了600名中国髋关节和膝关节外科医师协会成员，他们对未优化的医疗合并症和社会经济因素的看法是否会影响提供外科手术的倾向。
结果：在分布式调查中，收到150份答复，最终反应率为25%。数据表明，98.7％的中国外科医生对具有可改变的危险因素的患者进行关节置换术的限制，营养不良的频率显著(93.3%)，贫血（91.3%），最近注射透明质酸（HA在一个月内，88.7%)，和皮质类固醇注射（CS在三个月内，74.7%）。手术前的评估标准包括限制，例如体重指数低于40（47.3％），戒烟要求(57.3%)，可接受的血红蛋白A1c水平（95.3%），和依赖性空腹血糖水平（88％）。此外，87.3%的受访者表示需要对某些社会经济上处于不利地位的患者进行额外的干预，以取得成功的结果。大多数受访者(94.7%)认为更公平地获得护理，由更好调整的支付方法推动，可以提高患者的治疗效果。大多数人还认为当前的支付计划可能会损害社会支持不足的患者的结果（80.7％），社会经济地位低(67.3%)，和那些缺乏保险的人(72.7%)。
结论：在关节成形术前解决可改变的危险因素方面，几乎99%的反应率与AAHKS调查中报道的实践密切相关。这些发现强调了中美关节成形术外科医生对术前风险因素优化的共同评价，尽管医疗保健系统结构不同。
方法：对中国队列的AAHKS调查工具进行了调整。该调查询问了600名中国髋关节和膝关节外科医师协会成员，他们对未优化的医疗合并症和社会经济因素的看法是否会影响提供外科手术的倾向。
结果：在分布式调查中，收到150份答复，最终反应率为25%。数据表明，98.7％的中国外科医生对具有可改变的危险因素的患者进行关节置换术的限制，营养不良的频率显著(93.3%)，贫血（91.3%），最近注射透明质酸（HA在一个月内，88.7%)，和皮质类固醇注射（CS在三个月内，74.7%）。手术前的评估标准包括限制，例如体重指数低于40（47.3％），戒烟要求(57.3%)，可接受的血红蛋白A1c水平（95.3%），和依赖性空腹血糖水平（88％）。此外，87.3%的受访者表示需要对某些社会经济上处于不利地位的患者进行额外的干预，以取得成功的结果。大多数受访者(94.7%)认为更公平地获得护理，由更好调整的支付方法推动，可以提高患者的治疗效果。大多数人还认为当前的支付计划可能会损害社会支持不足的患者的结果（80.7％），社会经济地位低(67.3%)，和那些缺乏保险的人(72.7%)。
结论：在关节成形术前解决可改变的危险因素方面，几乎99%的反应率与AAHKS调查中报道的实践密切相关。这些发现强调了中美关节成形术外科医生对术前风险因素优化的共同评价，尽管医疗保健系统结构不同。
