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 While surgery doesn’t restore the same level of comfort and function
patients had in their younger years, before they developed
arthritis, the authors write in the journal Arthritis and
Rheumatology that knee replacement can serve as a time machine of
sorts, turning back the clock to a point when patients were less
disabled.
Researchers examined how much pain improved from six months before
knee replacement until six months afterward in 315 patients with
osteoarthritis, the most common form caused by wear and tear on
cartilage, and in 834 patients with RA, an immune system disorder
that causes joint swelling.
“The vast majority of patients had their symptoms improve
dramatically from the surgery, but this procedure is not a cure – RA
patients will continue to need to treat their disease outside of the
joint replacement,” senior study author Kaleb Michaud said by email.
Knee replacement is one of the most common surgeries, with about
720,000 people in the U.S. alone getting this procedure last year,
according to the Centers for Disease Control and Prevention.
During the operation, surgeons cut out damaged bone and cartilage
from around the kneecap, shin and thigh and replace it with an
artificial joint typically made of metal and plastics. Like any
surgery, there’s a risk of blood clots and infections, and this
particular operation can sometimes need repeating if the replacement
joint wears out.
Michaud, a rheumatology and immunology researcher at the University
of Nebraska Medical Center in Omaha, and colleagues set out to see
if surgical outcomes might differ based on whether patients had
rheumatoid arthritis or osteoarthritis.
While the procedure is often done to relieve chronic pain in both
types of arthritis, doctors remain divided over which people are
most likely to benefit.
Patients were typically in their 60s, overweight and educated at
least through high school. Most of them had been living with
arthritis for at least a decade.
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Rheumatoid arthritis patients getting surgery in the study were more
likely to be male, younger, lower weight and less educated. They
also reported significantly less pain at the start of the study, six
months prior to surgery.
After surgery, improvements in pain and quality of life were more
pronounced for patients with osteoarthritis.
One limitation of the study is its reliance on patients to
accurately assess their own pain and report changes to researchers,
the authors note.
Surgery can help people with severe pain and disabilities that don’t
respond to alternative treatments such as weight loss, exercise,
physical therapy and medication for osteoarthritis, said Francois
Desmeules, a researcher in rehabilitation at the University of
Montreal.
“Patients are usually satisfied with the procedure,” Desmeules, who
wasn’t involved in the study, said by email. “But they need to
realize that it is good for pain relief, which is obviously
important, but they might not get back to doing all the chores
around the house, leisure activities and sports that they used to
do.”
SOURCE: http://bit.ly/1DHjH6S Arthritis & Rhematology, online July
20, 2015.
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