Many Elderly Patients Not Offered Joint Replacement

Most elderly patients experience significant functional improvement following hip or knee replacement

TUESDAY, July 15 (HealthDay News) -- While recovery may be lengthy, most elderly patients undergoing joint replacement have excellent outcomes, according to an article published in the July 14 issue of the Archives of Internal Medicine.

Mary Beth Hamel, M.D., of Beth Israel Deaconess Medical Center in Boston, and colleagues conducted a prospective cohort study of 174 patients with severe osteoarthritis of the hip or knee, that failed conservative therapy, and examined symptoms and functional status.

In the cohort studied, the average Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score at study entry was 56 on a 100-point scale. In the 29 percent of the cohort undergoing joint replacement surgery, there were no deaths, but 38 percent experienced postoperative pain lasting greater than one month. WOMAC scores improved significantly in those undergoing surgery (24 points versus 0.5 points) and improvements were seen in both groups of patients studied (those aged 65 to 74 years and those aged 75 or older). Of the 71 percent of the cohort who did not undergo surgery, 45 percent reported that surgery was not offered as a potential treatment option.

"Elderly patients who had joint replacement surgery for severe osteoarthritis of the hip or knee took several weeks to recover but experienced excellent long-term outcomes," according to the authors. "Improved communication between physicians and patients may allow more elderly patients to make informed choices and to thoughtfully weigh the risks and burdens of joint replacement surgery against its benefits in alleviating pain and improving function and quality of life."

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