Johns Hopkins Health Alert
How Old is Too Old for Knee Replacement Surgery?
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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