Journal of Bone and Joint Surgery

Journal of Bone and Joint Surgery

MANKATO — A new study suggests timing is everything, at least when it comes to getting the most out of your knee replacement surgery.

And apparently most people wait too long for the procedure, according to long-term research into more than 8,000 people with or at risk of knee osteoarthritis in the U.S.

The findings published in Monday’s Journal of Bone and Joint Surgery found about 90% of people with osteoarthritis linger in pain longer than they should before receiving knee replacements. Another 25% don’t yet need the procedure, get it anyway, and receive minimal benefits as a result.

“Undergoing total knee replacement too early may result in little or no benefit while exposing the patient to the risks of a major operation,” concluded the researchers from Northwestern University. “Whereas waiting too long may cause limitations in physical activity that in turn increase the risk of additional disability and chronic disease.”

Dr. Kyle Swanson, hip and knee replacement surgeon at Orthopaedic & Fracture Clinic, said the majority of patients he sees have been experiencing enough pain to warrant a procedure.

“Most people that come are very frustrated with their situation,” he said.

Dr. Jacob Ziegler, orthopedic surgeon at Mayo Clinic Health System in Mankato, said he more often sees patients who aren’t quite at the point of needing knee replacements.

“For what I tend to see it’s more often folks who aren’t quite a great candidate for a joint replacement, but they’re sort of in this in-between time,” he said.

Those folks are often physically active and want to remain that way. The challenge for surgeons is to address their pain while making sure the patients understand artificial joints have their limits.

“I have folks who run marathons on knee replacements,” Ziegler said. “They’re the aberration, not the norm.”

The surgery is more designed for people to maintain their day-to-day standard or living. Recipients can still keep physically active, of course, but asking too much of an artificial solution can lead to disappointment.

For those who do wait for knee replacements, Swanson said it becomes a problem when joint pain is impacting other parts of the body. He gave the example of someone who’s no longer able to exercise, leading to worse heart health, mental health or other health indicators.

As for the right timing for the procedure, he said pain is the leading indicator for when it becomes appropriate.

“There’s only really one threshold or one indication and that’s pain,” Swanson said. “...Pain is the barometer to seek attention.”

Follow Brian Arola @BrianArola.

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