JOINT REPLACEMENT NO PAIN-FREE GUARANTEE (Orthopedics This Week)
Only half of the patients with arthritis who get a hip or knee replaced report a significant improvement in their pain and mobility after their surgery, according to a study reported by Mark Hoffman in Science World Report. According to the study’s lead author, Gillian Hawker, M.D., “Many patients with hip and knee arthritis have the condition in more than one of their hip or knee joints. So it’s not surprising that replacing a single joint doesn’t alleviate all their pain and disability. Patients may need subsequent surgeries to maximize the benefits of joint replacement.”
Women’s College Hospital and the Institute for Clinical and Evaluative Sciences (ICES) led the study which followed a cohort of 2,400 patients with osteoarthritis and inflammatory arthritis in Ontario. Hoffman reported that nearly 480 had a hip or knee replacement and of the 202 patients included in the study, only half reported a meaningful improvement in their overall hip and knee pain and disability one to two years after surgery. The researchers found that the patients who had the most acute knee or hip pain prior to the surgery but had fewer general health problems and no arthritis outside of the replaced joint were more likely to report benefits.
“While demand for joint replacement surgery has increased as our population ages, physicians lack a set of established criteria to help determine what patients will benefit from surgery and at what point during the course of the disease,” said Hawker who is physician-in-chief at Women’s College Hospital and a senior scientist at ICES. “As physicians, we need to do a better job of targeting treatments to the right patient at the right time by the right provider.”
Arthritis is a leading cause of disability in Canada. According to the Arthritis Society, joint damage from osteoarthritis is responsible for more than 80% of hip replacement surgery and 90% of knee surgeries in Canada.