New York Times: Hold off on knee replacement until it's necessary

New studies indicate that too many people may be deciding, prematurely, to go under the knife and have knee replacement surgery when they would be better off postponing the procedure until later in life, and opting for alternatives like exercise and weight loss in the near term.

More than 600,000 knee replacements were done in 2012 versus roughly 250,000 performed 15 years ago, according to a blog published by The New York Times (a related article ran in the newspaper's Sunday edition). It cited the American Academy of Orthopaedic Surgeons as saying knee replacements in people between the ages of 45 and 64 rocketed 205% higher between 2000 and 2012 while those over the age of 65 saw an increase of 95%.

In one study, researchers at Virginia Commonwealth University in Richmond conducted a surgical validity assessment using criteria developed in Europe. They found of the almost 200 subjects who had knee replacement surgery within 5 years of entering the study about one-third didn't meet the criteria needed to be considered appropriate candidates for the procedure.

The same researchers conducted a separate study that found that subjects considered good candidates for the procedure saw a substantial benefit with their new knee. They reported less pain in the joint and better physical function in the months following recuperation, and again two years later. Their scores on a knee function measurement test improved an average of 20 points. On the other hand, those who weren't considered good candidates only saw, on average, scores about 2 points higher.

The bottom-line message from the studies: Replacement knee devices, like the real thing, wear out after time. So, if you're in your mid-40s and go in for the procedure, you might not see that much improvement, and you could be looking at another knee replacement later in life.

"Ask your doctor how advanced your arthritis really is," Daniel Riddle, who led the studies, told the Times. He also went on to say that if bone-on-bone on arthritis isn't present, which means all the cartilage in the knee that acts as a cushion is gone, look for a physical therapist to talk about an exercise routine that can strengthen the knee. He also said losing weight can help.

- read the NYT blog

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