Senior Citizens with Osteoarthritis Do Just Fine
After Hip or Knee Replacements
Patients 75 and older took about the same amount of
time to return to regular activities as those age 65 to 74
July 14, 2008 - 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.
The number of U.S. senior citizens with
osteoarthritis is increasing rapidly, as the population of those age 65
and over mushrooms. The disease causes debilitating pain and often
restricts mobility of the elderly. Non-invasive treatments such as
medications and physical therapy appear to be of limited value for the
advanced stages of osteoarthritis. Surgery, however, may be associated
with risks and discomfort.
Mary Beth Hamel, M.D., M.P.H., and colleagues at
Beth Israel Deaconess Medical Center, Boston, studied medical
decision-making and treatment outcomes in 174 patients age 65 and older
(average age 75.2) who had severe osteoarthritis of the hip or knee.
Participants arthritis symptoms and functional
status were assessed at the beginning of the study, between 2001 and
2004, and again 12 months later. Patients who chose to have joint
replacement surgery were assessed six weeks, six months and 12 months
after the procedure.
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.
About Osteoarthritis
Also called: Degenerative joint disease, OA,
Osteoarthrosis
Osteoarthritis is the most common form of
arthritis. It causes pain, swelling and reduced motion in your
joints. It can occur in any joint, but usually it affects your hands,
knees, hips or spine.
Osteoarthritis breaks down the cartilage in your
joints. Cartilage is the slippery tissue that covers the ends of bones
in a joint. Healthy cartilage absorbs the shock of movement. When you
lose cartilage, your bones rub together. Over time, this rubbing can
permanently damage the joint. Factors that may cause osteoarthritis
include
● Being overweight
● Getting older
● Injuring a joint
Therapies that manage osteoarthritis pain and
improve function include exercise, weight control, rest, pain relief,
alternative therapies and 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.
Editor's Note: This study was supported by the Paul
Beeson Physician Faculty Scholars in Aging Research Program.
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July 14, 2008 - 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.