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Joint Replacements Cut Pain for Seniors

Researchers Say Disability Rates Are Down Due to Rise in Joint Replacement Surgery

Reviewed by Louise Chang, MD on November 12, 2007
From the WebMD Archives

Nov. 12, 2007 (Boston) -- Joint replacement surgeries are making a big dent in the pain and disability rates of senior citizens with arthritis, according to new research presented at the annual meeting of the American College of Rheumatology in Boston.

Researchers conducted the new study to learn why there has been about a 2% reduction in the amount of disability among senior citizens each year for the past several years.

Increasing numbers of total joint replacement surgeries may be responsible for this decrease, report the researchers, who were led by Eliza Chakravarty, MD, assistant professor at Stanford University School of Medicine in Palo Alto, Calif. There has been a fourfold increase in total joint replacements among senior citizens since 1982.

Researchers developed hypothetical scenarios to help estimate the impact of total joint replacement on national disability in people over the age of 65. They combined estimates on how the surgery affects disability -- using a standardized self-assessment measure of functional ability called the health assessment questionnaire (HAQ) -- with estimates of the increasing use of hip and knee replacements across the U.S. They also reviewed pre- and post-surgery and data on 483 patients who underwent total joint replacement.

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Senior citizens who underwent joint replacement surgery showed improvements in their HAQ scores as well as a 20% reduction in their pain levels in the first year after surgery.

Overall, the increasing number of joint replacement surgeries accounts for about 4%-5% of the national decline in disability for senior citizens, the researchers conclude.

And this decline could be even steeper if more seniors underwent joint replacement surgery, says Jeffrey N. Katz, MD, the director of the Orthopaedics and Arthritis Center for Outcomes Research at Brigham and Women's Hospital in Boston.

"The bottom line is that joint replacements are extremely effective, and there are a lot of older patients who are candidates who aren't getting them," he tells WebMD. "By doing joint replacements, we are alleviating pain and disability, and by doing more joint replacements, we could be alleviating even more pain and disability."

Advanced age does not prohibit someone from getting this operation, Katz says. "You can be too sick [to undergo the surgery], but you can't be too old for joint replacements."

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Sources

SOURCES: 2007 annual meeting of the American College of Rheumatology, Boston, Nov. 6-11, 2007. Eliza Chakravarty, MD, assistant professor, Stanford University School of Medicine, Palo Alto, Calif. Jeffrey N. Katz, MD, director, Orthopaedics and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston; associate professor of orthopaedics and physician researcher, Harvard Medical School, Boston.

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