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Johns Hopkins Health Alert

How Old is Too Old for Knee Replacement Surgery?

Comments (4)

You've tried analgesic creams, pain medications, exercise, physical therapy, and assistive devices to soothe the pain of your osteoarthritis. Maybe you've even lost 20 lbs. But your joints are still so stiff and painful that you can't drive your car or participate in hobbies you enjoy. You’re considering surgery, but wonder if you’re too old. In this Health Alert, a reader asks: I'm 74 years old and have severe osteoarthritis. I am considering knee replacement surgery, but I wonder if I'm too old. Here’s what the research shows …

A. You're not. Even osteoarthritis patients 75 and older appear to benefit greatly from joint replacement surgery, as a recent study in the Archives of Internal Medicine indicates.

Researchers followed 174 elderly patients with severe knee or hip osteoarthritis -- average age 75 -- for 12 months, assessing them at six weeks, six months, and one year. During that time, 29% (47) had joint replacement surgery. Although most of them took several weeks to recover, the long-term results were less pain and disability from osteoarthritis.

There were no deaths, but complications such as an infection or a blood clot in the lungs occurred in 17%, and 38% had pain for longer than a month. But, on average, those who had surgery were walking in less than two weeks and doing housework after seven. Their scores on a standard scale measuring pain and function had improved 50% at the 12-month follow-up. All but one felt they'd made the right choice to have the surgery. And patients over 75 had similar benefits and recovery as those in the 65 to 74 age range.

Many people who opted out of surgery expressed fears about the surgery itself and about recovery. But the study clearly suggests that elderly people with severe osteoarthritis should at least discuss joint replacement with their doctor.

Posted in Arthritis on April 5, 2010
Reviewed October 2011


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Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

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I had knee surgery last July. I've had open heart surgery, testicular surgery, rectal surgery and none of them compared to my knee surgery. I had 52 days of unrelenting pain. I went through weeks of PT. I had the operation as I could no longer tie my shoe on the right side. And there was some mild soreness on the knee itself. I still can't tie my shoe and now have pain not only of the knee, but in the back of my thigh as well.As I talk to others who have had the same operation, I find I am not the only one who has suffered these consequenses! Could the medical profession be playing down the short and long term effects of this surgery?

Posted by: jmdoc | April 5, 2010 10:20 AM

I had knee surgery last July. I've had open heart surgery, testicular surgery, rectal surgery and none of them compared to my knee surgery. I had 52 days of unrelenting pain. I went through weeks of PT. I had the operation as I could no longer tie my shoe on the right side. And there was some mild soreness on the knee itself. I still can't tie my shoe and now have pain not only of the knee, but in the back of my thigh as well.As I talk to others who have had the same operation, I find I am not the only one who has suffered these consequenses! Could the medical profession be playing down the short and long term effects of this surgery?

Posted by: jmdoc | April 5, 2010 10:20 AM

Overall health permitting, age seems to be no issue. My mother had total knee replacements (one knee at a time) at age 86, a little over a year ago. Within 3 months she was bowling again in two senior leagues. She has almost no pain now, occasional discomfort where one nerve may still be healing. She can anything but kneel, which is somewhat painful, but she does her own housework, gardens, travels. She has always been very active and lives alone. I wonder if you could benefit from more therapy to address constrictions in muscles or other soft tissue?? The leg is a complex system and fixing the joint may not address related issues that developed as you tried to live with a damaged joint.

Posted by: Dysie | April 5, 2010 4:50 PM

I had complete right knee replacement surgery in January 2008 when I was 74. I was walking well within days (with pain) and had several weeks of PT. I was a model patient.

However, I still have pain in that knee, especially below the operated knee. In a requested follow-up visit after about 8 months, the surgeon showed me the x-ray -- picture perfect -- but that knee still hurts. I had further PT with little results. Then they suggested I go to Curves an exercise facility for women only). After 135 visits (averaging three times weekly) I am still experiencing knee pain.

I was told that unfortunately some people do have post-operative pain. Those that don't are very lucky in my opinion.

I manage to do my daily tasks; keeping busy helps me forget about the pain. However, I cannot kneel on that knee without lots of cushioning below it. My internist told me I should not kneel on it, something the surgeon never told me.

Some days are worse than others. I usually ice the knee at least once a day and also use Icy-Hot gel. I am taking Tramadol for arthritis pain in several other areas of my body (back, neck, shoulder).

Would I do it again for the left knee? Fortunately I don't seem to have arthritis in that knee. I doubt that I would have the surgery, though, if needed as the pain I experience is about the same as it was before I had surgery.

Posted by: souplady | April 10, 2010 5:50 PM

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