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Our objective was to elucidate surgeons' perspectives on appropriateness for <jats:styled-content style=\"fixed-case\">TJA<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Semi\u2010structured telephone interviews were conducted in a sample of orthopaedic surgeons that perform <jats:styled-content style=\"fixed-case\">TJA<\/jats:styled-content> in three <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>anadian <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>rovinces. Surgeons were asked to discuss their criteria for <jats:styled-content style=\"fixed-case\">TJA<\/jats:styled-content> appropriateness for osteoarthritis; potential value of a decision\u2010support tool to select appropriate candidates; and the role of other stakeholders in assessing appropriateness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 17 surgeons approached for participation, 14 completed interviews (12 males; 7 aged &lt;50 years; 5 academic; 8 in urban practices). Surgeons agreed that pain and pain impact on patients' quality of life and function were the key criteria to assess appropriateness for <jats:styled-content style=\"fixed-case\">TJA<\/jats:styled-content>, but that these concepts were difficult to assess and not always congruent with structural changes on joint radiography. Some used a wider range of criteria, including their assessments of patient expectations, ability to cope and readiness for surgery. While patient age was not identified as a criterion itself, surgeons did acknowledge that appropriateness criteria may differ for younger versus older patients. Most agreed that a decision\u2010support tool would help ensure that all elements of appropriateness are assessed in a standardized manner, albeit the ultimate decision to offer surgery must be left to the discretion of surgeons, within the context of the doctor\u2013patient relationship.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Surgeons recognized the need for a tool to support decision making for <jats:styled-content style=\"fixed-case\">TJA<\/jats:styled-content>, particularly in the context of increasing surgical demand in younger patients with less severe arthritis. The work to develop and test such a decision\u2010support tool is underway.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jep.12449","type":"journal-article","created":{"date-parts":[[2015,9,8]],"date-time":"2015-09-08T11:03:54Z","timestamp":1441710234000},"page":"164-170","source":"Crossref","is-referenced-by-count":33,"title":["Perspectives of orthopaedic surgeons on patients' appropriateness for total joint arthroplasty: a qualitative study"],"prefix":"10.1111","volume":"22","author":[{"given":"Lucy","family":"Frankel","sequence":"first","affiliation":[{"name":"Department of Medicine Women's College Hospital  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Sanmartin","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences University of Calgary  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6358-1197","authenticated-orcid":false,"given":"Gillian","family":"Hawker","sequence":"additional","affiliation":[{"name":"Department of Medicine Women's College Hospital  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyn","family":"De Coster","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences University of Calgary  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Dunbar","sequence":"additional","affiliation":[{"name":"Division of Orthopaedics Department of Surgery Dalhousie University  Halifax Nova Scotia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Bohm","sequence":"additional","affiliation":[{"name":"Department of Surgery Concordia Joint Replacement Group University of Manitoba  Winnipeg Manitoba Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Noseworthy","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences University of Calgary  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,9,8]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200405000-00012"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2006.12.008"},{"issue":"7","key":"e_1_2_6_4_1","first-page":"1745","article-title":"Health related quality of life outcomes after total hip and knee arthroplasties in a community based population","volume":"27","author":"Jones C. 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