Only half of arthritis patients who undergo hip or knee replacement report a significant improvement in pain and mobility, according to a study that raises new questions about the effectiveness of such procedures.
The research, led by Women's College Hospital and the Institute for Clinical and Evaluative Sciences, is based on an analysis of 2,400 patients with osteoarthritis and inflammatory arthritis in Ontario. Nearly 480 had a hip or knee replacement and, of the 202 patients included in the study, only half reported a meaningful improvement in pain and disability one to two years after surgery.
"Many patients with hip and knee arthritis have the condition in more than one of their hip or knee joints," said Gillian Hawker, M.D., who led the study, published in the journal Arthritis & Rheumatism. "So it's not surprising that replacing a single joint doesn't alleviate all their pain and disability — patients may need subsequent surgeries to maximize the benefits of joint replacement."
Arthritis is a leading cause of disability in men and women. Joint damage from osteoarthritis is responsible for more than 80 percent and 90 percent of hip replacement and knee surgeries, the researchers noted. About 25 percent of patients who undergo a single joint replacement will have another joint replacement — usually the other hip or knee — within two years.
"While demand for joint replacement surgery has increased as our population ages, physicians lack a set of established criteria to help determine what patients will benefit from surgery and at what point during the course of the disease," said Dr. Hawker, physician-in-chief at Women's College Hospital and a senior scientist at ICES. "As physicians, we need to do a better job of targeting treatments to the right patient at the right time by the right provider."
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