Joint Replacement for Osteoarthritis: Benefits, Risks, and What to Expect
Osteoarthritis treatments: joint replacement
Professor David Hunter, rheumatologist
Joint replacement is replacing the surface of your joint with either metal ceramic or titanium. These are artificial substances which can be implanted into the joint to help the weight-bearing surface of the joint. These are used in a person that's failed other conservative treatment modalities and particularly there they've tried losing weight, doing exercise, trying a cognitive based therapies and using medication but despite that they still have significant pain, limitation function and disability related to their osteoarthritis. It's important that the person understands that this should be done for pain it shouldn't just be done because your X-ray shows that you have osteoarthritis and the surgeons sees an x-ray and it says that you have osteoarthritis this is done for pain and Improvement of function as a consequence of unrelenting symptoms that haven't responded to other appropriate treatments for your osteoarthritis.
Risks & benefits
The benefit of a joint replacement in the context of osteoarthritis is improvement in pain and about 95 percent of people that have a hip replacement can expect an improvement in pain and improvement and function about 75 to 80 percent of people have a knee replacement can expect a satisfactory outcome in terms of relief of their pain and Improvement and function again about 12 months after the procedure. It takes a while for them to recover from the surgery, this is significant surgery and it also carries with its substantial risk about 1 to 2 percent of people are likely to get an infection in their joint after the procedure, they may also develop a clot in the limb that they've been operated on that may also have other effects in terms of being dislodged and going elsewhere about 1 in 200 people die perioperatively as a consequence of their joint replacement and this is more likely to occur in older people with other comorbidities, particularly heart and lung related disease. So, for a knee replacement about 1 in 3 people may not necessarily redeem an improvement in their pain and it may actually either stay the same or get worse that commonly occurs in the context of an inappropriate diagnosis being made in the first instance and the pain related to what you thought was osteoarthritis may be a referred pain from somewhere else and/or you have substantial comorbidity, particularly depression that interferes with your ability to respond appropriately to a joint replacement. So, in the context where you're unsure whether the pain in your knees coming from the osteoarthritis and or you're depressed, really go out and try and find the best treatment option that's suitable for you before you go down a surgical treatment option.
