Update on hip and knee arthroplasty: current state of evidence.

Introduction Total hip (THA) and total knee (TKA) arthroplasties are cost-effective interventions for reducing pain, improving function, and enhancing the quality of life in patients with arthritis of the hip and knee (1,2). More than 193,000 THA and 381,000 TKA procedures are performed in the US each year (3), and future projections indicate that by the year 2030, more than 750,000 of these procedures will be performed per year (4). Therefore, it is imperative for health care professionals to practice evidence-based medicine by integrating the scientific literature with their clinical expertise and the patients’ preferences to select the most effective treatment interventions for enhancing patient recovery after joint replacement (5). In response to this need, the Association of Rheumatology Health Professionals, a division of the American College of Rheumatology, assembled a multidisciplinary group of experts from the US and Canada in a conference to review the current evidence on hip and knee arthroplasty. The purpose of the conference was to provide stateof-the-art information for health care professionals on the surgical procedures, preoperative interventions, biomechanical considerations, rehabilitation strategies, outcomes assessment, and health disparities related to THA and TKA. We present the findings from that conference, which synthesizes the available evidence in each area, identifies the gaps in knowledge, and provides suggestions for future research.