Some patients dissatisfied with knee replacement outcomes — 6 takeaways

Although knee replacements are largely considered successful, some recipients said their pain returned after surgery, according to a Kaiser Health News report.

Here are six takeaways:

1. Some patients KHN interviewed were happy with their results, while others said their pain returned. Based on a study from 2010, the outlet reported that one in five knee replacement patients weren't satisfied with the results.

The KHN report notesd, "Most knee replacements are considered successful, and the procedure is known for being safe and cost-effective."

2. Knee replacement had "minimal effects on quality of life," particularly for patients with less severe arthritis, according to a 2017 BMJ study cited in the report.

3. Society for Patient Centered Orthopedics President and orthopedic surgeon James Rickert, MD, said he believes physicians perform too many knee replacements. Some healthcare organizations, such as Blue Cross Blue Shield of California, have created written materials and videos to help patients make informed decisions and avoid inappropriate joint replacements.

4. Knee replacement procedure rates doubled from 1999 to 2008, and analysts estimate 3.5 million procedures will be performed annually by 2030. Agency for Healthcare Research and Quality data showed the percentage of knee replacements performed on patients ages 45 to 64 grew from 30 percent in 2000 to 40 percent in 2015.

5. The increase could be driven by a higher rate of youth injuries and physicians' increased willingness to operate on younger patients because new implants can last longer, Dr. Rickert told KHN. However, implants may not last as long for patients who are obese, and younger patients may need revision procedures if they outlive their implants.

6. KHN referenced a 2018 study published in Osteoarthritis and Cartilage, which compared surgical and non-surgical outcomes in 100 older patients eligible to undergo knee replacement.

Patients randomly assigned to undergo immediate knee replacement improved twice as much as those who had combination therapy. Surgical patients developed four times as many complications. Most patients treated with non-surgical therapies were satisfied with the outcomes, and two-thirds chose not to have knee replacement later although they were eligible.

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