Go to the Globe and Mail homepage

Jump to main navigationJump to main content

Woman suffering from pain in knee Collection: Hemera Item number: 95389837 Title: No title License type: Royalty-free Max file size (JPEG): 10 x 6.8 in (3,000 x 2,043 px) / 300 dpi Release info: No release required Keywords: Accident, Adult, Anatomy, Bone, Color Image, Complaining, Condition, Cure, Distraught, Emotional Stress, Exercising, Healthcare And Medicine, Healthy Lifestyle, Horizontal, Human Body Part, Human Knee, Illness, Massaging, Medicine, Men, Pain, Photography, Physical Injury, Pulling, Sadness, Sport, Sports Training, suffer, Symptom, syndrome, Tender, Tendon, Tortured, Treat, Arthritis
Woman suffering from pain in knee Collection: Hemera Item number: 95389837 Title: No title License type: Royalty-free Max file size (JPEG): 10 x 6.8 in (3,000 x 2,043 px) / 300 dpi Release info: No release required Keywords: Accident, Adult, Anatomy, Bone, Color Image, Complaining, Condition, Cure, Distraught, Emotional Stress, Exercising, Healthcare And Medicine, Healthy Lifestyle, Horizontal, Human Body Part, Human Knee, Illness, Massaging, Medicine, Men, Pain, Photography, Physical Injury, Pulling, Sadness, Sport, Sports Training, suffer, Symptom, syndrome, Tender, Tendon, Tortured, Treat, Arthritis

Joint pain, function not always better after surgery: study Add to ...

Only about half of people who have a knee or hip replaced see meaningful improvements in pain and disability in the months after surgery, according to a Canadian study.

Researchers found people who had worse knee or hip pain to begin with, fewer general health problems and no arthritis outside of the replaced joint were more likely to report benefits.

More Related to this Story

"I think this study really represents the general picture that often people do not have arthritis in just one joint," said Elena Losina, an orthopedic surgery and arthritis researcher from Brigham and Women's Hospital in Boston.

"It's of course good to set expectations appropriately that if you have three joints affected, doing one procedure is not going to be a miracle," said Losina, who co-wrote a commentary published with the new study.

Despite the rising popularity of joint replacement, uncertainty remains about which patients have the most to gain and who fares best post-surgery. So a team led by Dr. Gillian Hawker from the University of Toronto tracked about 2,400 older adults with osteoarthritis or inflammatory arthritis in Ontario  to see who went on to get surgery and how they did.

From the start of the study in 1996 through early 2011, 479 of them had a knee or hip replaced, including 202 who underwent elective surgery and had before and after pain and disability information available for analysis.

Most surgery patients were women with pain in more than one joint, and over 80 per cent were overweight or obese.

By a year or two after surgery, the average person had a 10-point improvement in pain and disability from a pre-surgery score of 46.5 out of 100, the research team wrote in Arthritis and Rheumatism.

A nine-point improvement is considered the "minimal important difference" in symptoms, and about 54 per cent of joint-replacement patients hit that target.

Unlike general health and other joint problems, people's weight did not predict how they did after a knee or hip replacement, Hawker and her colleagues found.

Losina said that even if a first joint replacement leaves people with some pain and disability, it may help them make incremental steps toward better health.

And doctors may need to realize that until some people get each of their painful joints replaced — not just one knee or hip — they're not going to have optimal outcomes, according to Hawker.

"We have to look at the whole patient, not just a single joint," she told Reuters Health.

Researchers said the new findings provide more evidence for patients and their doctors to use while discussing the pros and cons of knee and hip replacement.

"This is not an easy surgery, it's an expensive surgery, and I think people should understand what they are getting into and what are the expected outcomes," Losina told Reuters Health.

Andrew Judge, who has studied joint replacement outcomes at the University of Oxford in the UK, agreed these kinds of findings are important to help inform doctor-patient decision making.

"Further research is required in other large datasets in order to confirm these findings, and to identify other key determinants of good outcomes, to inform the development of a future clinical risk prediction tool," he told Reuters Health in an email.

Follow us on Twitter: @Globe_Health

In the know

Most popular video »

Highlights

More from The Globe and Mail

Most Popular Stories