Researchers say that as the U.S. population ages, the number of elderly with osteoarthritis is increasing, and noninvasive treatments, such as drugs and physical therapy, are of only limited value for severe cases.
Joint replacement surgery can relieve pain and restore function to the affected joints, but researchers say few older people with osteoarthritis are offered surgery as a potential treatment option because of the associated risks.
Surgery Option for Osteoarthritis
In the study, published in the Archives of Internal Medicine, researchers followed 174 older adults aged 65 or older (average age 75) with severe osteoarthritis of the hip or knee. The participants were evaluated between 2001 and 2004 and again a year later after treatment.
Overall, 29% of the participants had either hip or knee replacement surgery. Of those, 17% had complications following surgery, such as deep wound infection and blood clot in the lungs (pulmonary embolism); 38% had pain lasting more than four weeks after surgery.
No deaths were reported among those who had joint replacement surgery. Researchers found patients aged 75 and older took about the same amount of time to recover from surgery as those aged 65 to 74.
During recovery, most elderly patients required assistance with daily activities like shopping and household chores for more than a month.
A year after treatment, elderly patients treated with joint replacement surgery experienced more significant improvements in osteoarthritis symptoms than those who did not have surgery.
Researchers found that nearly half of the patients who did not have joint replacement surgery said surgery was not offered to them as a potential treatment. Those who did not have surgery also tended to be older, have lower incomes, and be more worried about surgical complications and a longer recovery than those who did have surgery.
"Many patients were not offered surgery or chose not to have surgery owing to concerns about postoperative complications or prolonged recovery," write researcher Mary Beth Hamel, MD, MPH, of Beth Israel Deaconess Medical Center in Boston and colleagues. "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."