|
E-mail this page to a friend!
Fitness & Exercise for Senior Citizens
Women, Arthritis Sufferers Recover More Slowly from
Arthroscopic Knee Surgery
Factors differ from long-term problems for older
people, more severe tears
 July 17, 2007 Women and people with
osteoarthritis do not recover as quickly from arthroscopic knee surgery,
according to new research. These people are not associated with poor
long-term recovery, which impacts those of advanced age, larger tears
and larger tissue removal. The study was released Saturday at the 2007
Annual Meeting of the American Orthopaedic Society for Sports Medicine.
We found that women showed poorer short-term
recovery than men in the first year following arthroscopic meniscal tear
removal surgery, and people with osteoarthritis also did not do as well
as others, says principal investigator Peter Fabricant, BS, a medical
student at Yale University School of Medicine in New Haven, Conn.
The factors associated with a poorer long-term
outcome, such as larger tear size, greater amount of tissue removed,
advanced patient age, and higher Body Mass Index, are not the same as
those we can associate with short-term surgical recovery.
The meniscus is the shock-absorbing tissue that
cushions the knee joint preventing the bones from rubbing. Tears in this
tissue can cause pain and loss of function. In arthroscopic partial
meniscectomy, the surgeon inserts small surgical instruments and a
camera through tiny incisions in the knee to remove torn tissue. An
estimated 636,000 arthroscopic knee procedures are performed annually,
according to the American Academy of Orthopaedic Surgeons.
Fabricant and colleagues at Yale University studied
126 patients who underwent arthroscopic partial meniscectomy to assess
the impact of obesity, age, gender, amount of tissue removed, and
degenerative joint changes on short-term recovery. They found that being
female and the extent of osteoarthritis were associated with a
less-than-optimal first-year recovery.
Other studies have shown that advanced age,
obesity, and the amount of meniscal tissue removed all negatively affect
long-term outcome from arthroscopic meniscal repair. In our study these
variables did not affect short-term recovery. Conversely, gender and
osteoarthritis appear to play a role in short-term recovery, as they
have been shown to do in the long-term, Fabricant comments.
The current medical literature only offers research
findings on long-term outcomes following arthroscopic meniscal repair.
We couldnt find anything in the literature to predict recovery during
the first year, explains Fabricant. Physicians need to be able to
discuss with patients how long it might be before they can return to
optimal function levels in work and activities of daily living.
Fabricant and colleagues suggest that severe
osteoarthritis in the knee may be a contraindication to surgery.
Arthritis may be a marker for a degenerated knee, which may not be able
to recover as well as a healthy, non-arthritic knee, Fabricant says.
Osteoarthritis may also be a marker for worse
overall knee function in general. Patients with severe osteoarthritis
already have loss of cartilage and soft tissue. Further tissue removal
appears to have minimal impact on patient knee pain and function during
the year following surgery.
The investigators say that it is unclear exactly
how female gender complicates surgical recovery. Fabricant notes that
there are gender differences both in surgical outcome and possibly in
the biomechanics resulting in how the knee was initially injured. Even
before surgery, women typically reported more knee pain and decreased
knee function compared to men.
Editor's Notes:
The American Orthopaedic Society for Sports
Medicine (AOSSM), a world leader in sports medicine education, research,
communication and fellowship, is an organization of orthopaedic sports
medicine specialists, including national and international sports
medicine leaders. The Society works closely with many other sports
medicine specialists including athletic trainers, physical therapists,
family physicians, and others to improve the identification, prevention,
treatment, and rehabilitation of sports injuries. Please visit the AOSSM
Web site,
www.sportsmed.org.
Click to More Senior News on the
Front Page
Copyright: SeniorJournal.com |
