Doctors are recommending knee replacement surgery to patients who may not
need it, according to a new study. It found that one-third of knee replacement
surgeries performed in the United States may be inappropriate.
The study is particularly relevant, given that the number of total knee
replacement surgeries performed in the U.S. doubled between 1991 and 2010.
The researchers analyzed data from approximately 4,800 U.S. patients with
knee osteoarthritis or at high risk of the condition. Of those, 205 underwent
total knee replacement surgery. Using established criteria for knee replacements
that consider factors such as pain severity and range of motion, surgeries
were characterized as appropriate, inappropriate, or inconclusive.
The study concluded that just 44 percent of the total knee replacements
were appropriate, while 34 percent were deemed to be inappropriate and
22 percent were considered inconclusive.
“We found that some patients undergo total knee replacement when
they have very low grade symptoms or minor knee arthritis,” lead
author Daniel L. Riddle of Virginia Commonwealth University told
Given the findings, patients should work closely with their doctors to
determine if they are good candidates for the surgery.
“The key issues, in addition to a reasonably healthy medical status,
are the extent of pain, extent of compromised function and extent of knee
osteoarthritis,” Riddle explained. “We have very good prognostic
data now and we know that persons with high levels of psychological distress,
minor knee osteoarthritis, serious (other health conditions) and multiple
joint arthritic disease are at greatest risk of poor outcome.”