Patients with Knee Problems May Want to Reconsider before Undergoing Knee Replacement

Getting a total knee replacement may seem like an appealing option for someone suffering from sore and creaky knees, but these devices may not be as beneficial as one would hope, according to Well, the New York Times health blog. In 2012, more than 600,000 knee replacement surgeries were performed compared to about 250,000 just 15 years ago.

Manufacturers of knee replacements often claim that the devices have a wide variety of benefits, offering increased mobility, less pain and overall a more youthful lifestyle. However, a growing body of evidence shows that many patients should try other methods to improve their knees first. Research suggests that many people are undergoing the procedures prematurely and gaining limited benefit. Figures from the American Academy of Orthopaedic Surgeons shows that in between the ages of 45 and 64, the number of knee replacements increased drastically by 205 percent between 2000 and 2012. The increase was only 95 percent in people 65 and older.

Researchers at Virginia Commonwealth University in Richmond conducted a surgical validity assessment for two major studies published this year, and found that knee replacements are not appropriate unless patients had arthritis that was medically proven to be advanced. This does not mean severe pain alone, but also includes impaired physical function such as the inability to get out of a chair or walk without aid, the Well blog noted. The researchers also determined that the devices are less suitable for patients under the age of 65 because the materials of the implant only last a couple of decades, meaning the patient would need to undergo another knee replacement in their lifetime.

Out of 200 men and women with aching, arthritic knees who underwent knee replacement surgery within five years of entering the study, researchers found that only about one third would have been considered an appropriate candidate based on their standards. A number of these participants only had mild arthritis.
The study was led by Dr. Daniel Riddle, who is a professor of physical therapy and orthopedic surgery at Virginia Commonwealth University. The take home point of the study is that patients should not resort to replacement unless their knees are essentially unusable. “Ask your doctor how advanced your arthritis really is,” Dr. Riddle said, according to Well. He advises consulting with a physical therapist about joint strengthening exercises and potentially losing weight if patients do not have bone-on-bone arthritis.

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