No pain no gain. Are Hip and Knee Replacements worth it?
Those who suffer from arthritis understand the daily grind...literally the 'grind' of bone on bone that you deal with everyday. Hip and knee replacements are often the last resort and a big committment on the part of the patient but here is some new data to suggest it is well worth it, even in older patients.
Researchers conducted this study to examine outcomes for patients 65 years or older with symptoms of knee or hip pain that were not controlled by conservative treatments (antiinflammatories, physical therapy).The question addressed in this study, published this month in the Archives of Internal Medicine, was whether the risks of surgery and the discomfort of recovery was worth the benefits. The conclusion of the authors was yes, though it took several weeks to recover, patients experienced excellent long-term outcomes. Here are some details:
WHAT TO EXPECT AFTER HIP OR KNEE REPLACEMENT SURGERY:
1) Patients who underwent surgery had symptoms and function assessed 6 weeks, 6 months and 12 months after surgery. The complication rate was 16.0% for patients aged 60 to 74 years and 18.8% for those 75 years or older; 38.3% had postoperative pain lasting more than 4 weeks.
2) The time it took after surgery to start with independent walking was 12 days on average and to perform household chores was 49 days, with similar times for patients ages 65 to 74 and 75 or older.
3) BOTTOM LINE: Symptoms scores at 12 months were MUCH improved in those who had replacement surgery compared to those who had not. This was true even more so for those 75 and older. So, even with the struggles after surgery patients were doing much better one year later than those who had not had surgery.
Dr O.
Categories: News
Support Groups: Arthritis, Arthritis - Juvenile, Back Pain, Chronic Pain, Degenerative Disc Disease, Degenerative Joint Disease, Lupus, Rheumatoid Arthritis
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Dr Orrange,
I am 39 with djd in both knees. Left is much worse. I am in total pain 20 hrs a day taking ibuprofin and its not helping. Can hardly sleep. Have been told to I need a knee replacement but I am too young!? Was wondering about weight issues too..Im too much in pain to walk to drop pounds but dont I need to lose weight (I am obese ) to have the surgery? In 2003 had an unsuccessful OATS procedure.. I have had a few cortisone injections with not much relief and dont want to take addictive pain pills on a regular basis....Advice Please???
By true2self December 15, 2008 10:11am
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Dr. Orrange,
I would be interested to know how this article would relate to people with RA (as opposed to OA). I understand that it makes no sense to replace joints of RA sufferers if the disease is still active. And, yet, many RA sufferers never attain remission. So, does this mean that they should not have replacement surgery at all? Does it mean that they should only have it if and when they attain remission? Also, if they are not in remission and choose to have surgery anyway (one of the members of my support group did that at the advice of one of her doctors and lived to regret it), is there anything that can be done once the decision to replace the joint is made?
Thanks for your advice on this one.
By D141092 October 8, 2008 3:19pm
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I have reflex sympathetic dystrophy syndrome and my hip has lost so much bone that it needs to be replaced, but doctors in my area won't do the surgery because of the RSD. Can you recommend a surgeon in Tennessee, North Carolina, or Virginia that might not be afraid to help?
By Sunflowers21 September 6, 2008 8:42pm
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I had a total hip replacement June 23, 2008 and was sorry I waited so long. The pain I endured waiting for the surgery was much worse than the recovery. I would definately have the other hip done much faster if necessary
By Shrn August 27, 2008 2:17pm
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Thanks for this article.
The doctors told me a year ago that I needed a partial kneed replacement but I've been holding off. It doesn't bother me a great deal unless I have to walk a lot.
The reason I have held off on getting the knee replacement is because I'm only 52 years old (my sister was told she needed a replacement at 39, rottn bones in the family I think) and I don't want to get the partial replacement only to wind up needing a total perhaps five years down the road.
What do you think?
By seraphina August 19, 2008 9:48am
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Hey Diane
Awesome advice and Im so glad you are here so others can read your comments. I have SO many patients who dred it and then cant believe they didnt do it sooner...
By DrOrrange August 11, 2008 12:11am
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Dr. Orrange, Thanks for sharing the info; I am testiment to the value of hip replacement. I had my right hip done July 23, 2007, at57 yrs old. I was terrified right up to the moment I went under anesthesia.
I had three weeks to ponder my final decision to have surgery. Now I wonder why I waited so long ! The pain had gotten so severe, I couldn't sleep, walk without a walker, and lost almost 30 pounds because the pain took away hunger. I had become so depressed, for the year before surgery, I rarely left the house and let cleaning of the house to my husband. Needless to say, our relationship had been steadily delining, which only added to my negative self feelings.
Recovery is no easy task; but worth the effort! I will have my left hip replaced this fall. The left hip is so painful, I'm using a cane all the time, and even need the walker on "bad" days--which are increasing by the day.
So, long winded me, do your research, find a doctor who specializes in hip replacement, a hospital with an excellent safety history, gather up your courage and go for it!! "Healing" time depends on many factors; discuss ALL your concerns with your surgeon....
I feel like I've gotten my life back; with the left hip surgery, I'll be able to resume 90 percent of life's activities!!
By DianeI August 7, 2008 10:37am