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, one of the JAMA/Archives journals.
Mary Beth Hamel, M.D., M.P.H., and colleagues at
During 12 months of follow-up, 51 patients (29 percent) had joint replacement surgery, including 30 knee and 21 hip replacements. None of these patients died, 17 percent had postoperative complications and 38 percent had pain lasting more than four weeks following surgery. Patients age 75 and older took about the same amount of time to return to regular activities as those age 65 to 74, with most patients requiring assistance with activities such as shopping and household chores for more than a 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. Close to half (45 percent) of patients who did not have surgery reported that surgery was not offered to them as a potential treatment. Participants who did not have surgery tended to be older, have lower incomes and be 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 conclude. “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.”
Arch Intern Med. 2008;168:1430-1440.