To replace or not to replace? Hip and knee replacements for those with osteoarthritis
In early 2018 it was found up to 1 in 4 knee and hip replacements for Australians with osteoarthritis were unnecessary.
Osteoarthritis is wear and tear that occurs in the joint over time. Most people aged 50 years and over have some osteoarthritis in the knee joint. It is a common belief that osteoarthritis causes pain, so those suffering from the pain associated with osteoarthritis often seek out replacements.
If you have osteoarthritis and are considering a hip or knee replacement, there’s a few important things to understand:
- Deterioration does not determine pain
- Age matters
- There are risks
- Other options to treat the pain
Deterioration does not determine pain
If you’re considering a replacement, it’s important to understand that the amount of pain someone experiences is not linked to how much deterioration is in the joint. Some people that have little deterioration can experience high levels of pain, whilst others with a lot of deterioration can experience little pain (see more at The Arthritis Foundation).
In fact, one study summarised it as “weak correlations between radiographic severity of OA and pain presence or severity.” Simply put, the amount of deterioration in a joint does not determine the amount of restriction in movement or pain someone experiences.
Having a knee or hip replacement also does not guarantee that you’ll be pain-free. One study found that 9% of people post a hip replacement were experiencing pain, and 20% or more of those that had knee replacements.
Age matters: The younger you are, the more likely you’ll need to get your replacement, replaced
The other consideration when looking at a knee or hip replacement is how soon a new one will be required. For those that have their first replacement before age 60, a 2017 study in The Lancent found the average time until replacement was 4.4 years.
Understandably, as the age of the first replacement increases, your likelihood of needing another replacement decreases (you might not outlive your replacement!). You can see a population-based study by the Lancet here.
There are risks: Infection, death, poor functional outcome and medical complications are potential risks
Like any operation, there are a number of risks associated with hip and knee replacements.
“Patients who are considering undergoing joint replacement should balance the potential benefits of an improvement in their quality of life against the potential risks of the intervention: death, medical complications, infection, poor functional outcome, and the need for revision surgery,” outlined a study published in The Lancet.
Take your time to understand both the potential benefits and the potential downsides.
Other options to treat the pain
Peter Choong, director of orthopaedic surgery at Melbourne’s St Vincent’s Hospital, has said: “People need to understand there can be much better ways to treat osteoarthritis, and surgery should be a last resort.”
Is pain your problem? At Liberated Health we restore the natural flow of energy in the body to eliminate pain.
- Knee and hip replacements ‘not needed by thousands of Aussies’ [The Australian]
- Needless procedures: Knee arthroscopy one of the least effective surgeries [UNSW Newsroom]
- Osteoarthritis [Arthritis Foundation]
- The effect of patient age at intervention on risk of implant revision after total replacement of the hip or knee: a population-based cohort study [The Lancet]
- The Epidemiology and Impact of Pain in Osteoarthritis