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Title: Joint Replacement Proves Beneficial to Elders With Osteoarthritis
URL: http://www.pslgroup.com/dg/225C2E.htm
Doctor's Guide
July 14, 2008

CHICAGO -- July 14, 2008 -- Older adults who have hip or knee replacement surgery for severe osteoarthritis may take several weeks to recover but appear to have excellent long-term outcomes, according to a report in the July 14 issue of Archives of Internal Medicine.

Mary Beth Hamel, MD, Beth Israel Deaconess Medical Center, Boston, Massachusetts, and colleagues, studied medical decision-making and treatment outcomes in 174 patients aged 65 years and older (mean age, 75.2 y) who had severe osteoarthritis of the hip or knee.

Patients' arthritis symptoms and functional status were assessed at the beginning of the study, between 2001 and 2004, and again 12 months later. Patients who chose to have joint replacement surgery were assessed 6 weeks, 6 months, and 12 months after the procedure.

During the 12 months of follow-up, 51 patients (29%) had joint replacement surgery, including 30 knee and 21 hip replacements. Of the patients, 17% had postoperative complications and 38% had pain lasting more than 4 weeks following surgery. None of the patients undergoing surgery died

Patients ages 75 years and older took about the same amount of time to return to regular activities as those aged 65 to 74 years. Most patients required assistance with daily activities such as shopping and household chores for more than 1 month.

At the 12-month mark, scores on scales measuring osteoarthritis symptoms improved more significantly in patients who had surgery than in patients who did not have surgery.

About 45% of patients who did not have surgery reported that surgery was not offered to them as a potential treatment. Patients who did not have surgery tended to be older, had lower incomes, and were more worried about surgical complications and a long recovery than those who did have surgery.

"Our findings of excellent outcomes from joint replacement surgery in elderly patients with severe hip or knee osteoarthritis corroborate and extend the findings of previous studies," the authors wrote.

"These data should help inform discussion about joint replacement surgery and allow patients to consider the risks and benefits of surgery as well as the expected postoperative recovery experience," the authors wrote.


SOURCE: Archives of Internal Medicine

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