When Is Best for TKA?Traditionally, orthopedic surgeons wait until patients' knee osteoarthritis (OA) is unbearable before doing a knee replacement. (The surgery is also called a total knee arthroplasty, or TKA.) But this situation is changing. There is still no clear best time for doing TKA.
These researchers compared results for 130 patients who underwent TKA. X-rays were used to rate the severity of OA. The patients were divided into two groups. One group had moderate OA based on the X-ray results. The second group had severe OA.
All the patients answered questions about knee pain and function before surgery and one year after surgery. Both groups reported roughly the same knee pain before and after surgery. Over 90 percent of patients in both groups showed improved knee function and pain after surgery, and both groups showed improvement to about the same levels. Notably, the patients with the least severe OA regained more ability to use their knees than those with more severe OA.
The researchers also noted that X-ray changes of OA were not that closely linked to OA symptoms described by patients. Other research has shown this as well.
The results suggest that surgeons need to rethink the idea of the best timing for TKA in patients with knee OA. The authors recommend more research to help find the best timing for the best possible results from surgery. The good news for patients with knee OA is that they may not need to wait until their knees are terribly painful and nonfunctional before getting a new joint.
S. Gidwani, BSc, MRCS, et al. Do Patients Need to Earn Total Knee Arthroplasty? In The Journal of Arthroplasty. March 2003. Vol. 18. No. 2. Pp. 199-203.
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