Research Studies Show Many Knee Replacements Done Too Early

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Two research studies show evidence that many people undergo knee-replacement sooner than necessary and they would be better off using other ways to relieve knee pain and improve physical  function before turning to knee-replacement surgery.

Knee replacement has become increasingly common: the American Academy of Orthopaedic Surgeons said knee replacements in people age 45 to 64 went up by 205 percent between 2000 and 2012. In 2012, more than 600,000 knee replacements were performed.  Just 15 years ago, the annual rate was about 250,000 such surgeries, according to the New York Times. Research studies suggest that people may be having the surgery prematurely, the Times reports.A group of researchers at Virginia Commonwealth University in Richmond assessed the surgical validity of knee replacements, evaluating surgeries using criteria developed in Europe, the Times reports. They concluded that knee replacements could be judged appropriate only for those with advanced arthritis in the knee.  The criteria include not only severe pain but also impaired physical function, like the inability to climb stairs, or to get out of a chair or walk without aid. The researchers determined that knee replacements are better suited for patients older than 65. Implant devices wear out after about 20 years – some fail earlier — and people receiving knee implants at younger ages may well need another replacement during their lifetime.

The researchers analyzed data on nearly 200 men and women who had knee replacement within five years of entering the study. Approximately one third of the subjects would not have been rated as appropriate candidates by the researchers. Many had only slight arthritis, according to scans of their knees or their reported level of pain and physical impairment. In a separate study, the researchers found that good candidates for knee replacement saw substantial benefits from the surgery. They experienced much less pain and greatly improved physical functioning, both in the months immediately after the procedure and again two years later. They improved about 20 points on a ranking scale. But in comparison, study subjects whose surgeries were deemed inappropriate showed only about a two-point improvement, the Times reports.