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April 24, 2013
Jewish World Review
New knee helps your heart
Harvard Health Letters
Here's another reason to get that knee replacement you've been debating: A new study presented at the 2012 Annual Meeting of the American Academy of Orthopedic Surgeons finds that adults with osteoarthritis face lower odds of developing heart failure by having a total knee replacement.
The study did not show a direct cause and effect or prove definitively that a total knee replacement (TKR) could improve cardiovascular health. However, the procedure does allow the recipient to exercise again, which can lead to better heart health.
And that's just one of the benefits of today's TKR.
"These days, total knee replacement lasts a long time. After 20 years of implantation, 80 percent of new joints survive. That's better than cars, washing machines and refrigerators," says Dr. Donald Reilly, assistant clinical professor of Orthopedic Surgery at Harvard Medical School.
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That's due in part to improved materials and streamlined techniques.
"Total knee replacement has over the last few decades become fairly standard," says Dr. Reilly. "The large majority of U.S. surgeons do a resurfacing operation."
In resurfacing, surgeons remove damaged cartilage at the ends of the thigh and shin bones, then implant metal and plastic components to act as the new surface of the joint. They may also resurface the underside of the knee cap.
Sometimes, only part of the surface of the knee bones needs to be resurfaced. This is called a partial total knee replacement. The procedures are reliable, with very few problems.
Complications that can require repeat surgery, like infection, instability, wear, fracture and loosening, occur at a rate of about 1 percent per year.
But even today's advanced TKRs come with a long recovery.
"We have gotten better with pain management after total knee replacement, but the postoperative course is hard and takes substantial effort in physical therapy by the patient," explains Dr. Reilly. "Patients who are in good shape can expect to climb stairs with crutches three to five days after surgery and walk comfortably on crutches by four weeks."
Dr. Reilly says physical therapy typically lasts two months and it may take six months for a patient to be able to climb the stairs without assistance. But most people are happy to have full use of their knee again.
"Four out of five people are glad they had their knee replaced," says Reilly.
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