Knee replacement patients function well after 20 years--study

Here is some heartening news for all those who keep enduring pain and put off total knee replacements (TKR) amid concerns that the quality of the result and the amount of function in the reconstructed knee decreases over time.

According to a new study, patients with artificial knees may exhibit some age related declines but maintain an active lifestyle over a long term, nearly another 20 years after their surgery.

Total knee replacement (TKR), also referred to as knee arthroplasty, is a surgical procedure where worn, diseased, or damaged surfaces of a knee joint are removed and replaced with artificial surfaces.

Total Knee replacement

The basic aim of the procedure is to help individuals return back to normal activities of daily living and provide them with painless and unlimited standing, sitting and walking capabilities.

Lead researcher of the study, Dr John Meding, an orthopedic surgeon at the Center for Hips and Knee Surgery at St. Frances Hospital Mooresville, in Mooresville, Ind. stated: "The whole point of having a total joint replacement is to maintain a functional knee that allows patients to maintain a good deal of activity for a long time. This shows it lasts 20 years or more after the [operation]."

He added: "If you get a good knee and treat it well, and are blessed to live long enough, even after 20 years you can maintain this level of activity.”The study found that with the exception of two patients all could use stairs without a banister and only three were confined to the house.

Functional capacity of patients after TKR assessed
In a bid to assess the patient's functionality after TKR, the researchers studied the outcome of the procedure in 1,757 patients who had the surgery at St. Frances between 1975 and 1989.

All had undergone a procedure known as primary cruciate-retaining surgery.

Among them, a total of 128 patients with an average age 82 were still living after their 20-year follow-up.

It was noted that 82 percent of these patients had osteoarthritis and 73 percent were female.

The study subjects were evaluated for knee flexibility, walking distance, ability to climb stairs and their level of pain.

Revelations of the study
The study found that with the exception of two patients all could use stairs without a banister and only three were confined to the house.

In addition, 95 patients could walk at least five blocks, while 82 reported unlimited walking ability. The study also found that 81 were pain free.

Additionally, 22 patients took part in sports such as jogging, volleyball and tennis, some also with both knees replaced.

Mending concluded: "These findings definitely add to the conversation with patients considering surgery. If a patient actually lives that long, a well-functioning TKR may help allow them to maintain a remarkable functional capacity and activity level not just for five or 10 years but for 20 years and beyond.

"This research refutes any perception that the importance of a well-functioning TKR diminishes over time because of an overall declining functional status. Elderly people are using their surgically replaced knees for fairly active lifestyles many years after surgery."

The findings of the study will be presented this week at the annual meeting of the American Academy of Orthopaedic Surgeons (AAOS) in San Diego.

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