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Stories for Reprint
Knee Replacement Reduces Pain
By Ferdous Al-Faruque, MARRTC Staff
A new study has found that total knee replacement surgery can help people with rheumatoid arthritis and osteoarthritis to reduce pain in their knees.
Researchers at the University of Nebraska and the National Data Bank for Rheumatic Diseases in Witchita, Kan., reviewed medical records of over 600 people with rheumatoid arthritis and almost 200 people with osteoarthritis who underwent total knee replacement for the first time. The researchers found that people in both groups had significantly less pain in their knees after surgery. They also found that the surgery seemed to have better results for people who had osteoarthritis than people who had rheumatoid arthritis. People with osteoarthritis had even less pain in their knees after the surgery, and used less medication for inflammation and pain.
Kaleb Michaud, an assistant professor of medicine at the University of Nebraska and the principal investigator of the study, says their findings are not that surprising. "In (osteoarthritis) you have one, two, or three joints that are affected," he says. "But (rheumatoid arthritis) has more (affected) joints and more body pain in general." He says this means people with RA have to deal with pain in more areas of their body that total knee replacement can't improve.
The study also found that people who had their knee replaced had a better quality of life after the surgery. "If you reduce pain, they can do a lot of things they couldn't do before and if you improve function they can achieve things they couldn't before," says Michaud. "And with both of those (improvements) you can improve other things such as depression."
People who have the surgery still have physical limitations and need to go through a period of rehabilitation therapy to get used to their new knees. So, healthcare professionals usually suggest total knee replacement surgery as a last resort for people with severe knee damage. Michaud says in most cases people are happy with their surgery, but in rare cases there are surgical complications and infections, and people can't undo their surgery. "It's one of those things that's irreversible," he says. "Once you replace a joint, you can't go back."
Michaud also says people need to understand that no matter how well the surgery and the recovery period go, there are always going to be limitations. "It does have a lot of benefits but you're not going to be a 20-year-old," he says. According to Michaud, before deciding to have their knees replaced, people should talk to their family and healthcare professionals to understand their own expectations from the surgery.
Despite these limitations, total knee replacement surgery has come a long way since surgeons began performing it back in the 1970s. According to Russell Windsor, an orthopedic surgeon at the Hospital for Special Surgery in New York, though the surgeries are generally a last resort for older people, new surgical techniques and knee replacement parts have made it more appealing to people even in their 50s. "There are rare cases where patients in their 40s or earlier (undergo the surgery)," he says.
From the most recent data, according to the Centers for Disease Control and Prevention, over half a million total knee replacement surgeries were performed in 2005 alone, and that number is growing every year.
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