Do you need to see a physical therapist after a joint replacement…. Maybe not
Home exercise effective after knee replacement
Hugo Wilcken writing in Rheumatology Update reported a monitored home exercise program in the first six weeks after knee replacement surgery has similar outcomes to standard rehabilitation, Sydney researchers report.
Their study looked at nearly 400 knee-replacement patients who were randomized to either a six-week monitored home exercise program or usual care, which generally involved clinic-based outpatient physiotherapy.
There were no significant differences between the two interventions in pain scores, physical function, knee flexion, knee extension or walk time, found the researchers from the Faculty of Health Sciences at the University of Sydney.
Comment: Good news because doing it yourself certainly is more convenient.
Told you need to get your knee replaced. Better get another opinion…
One third of total knee replacements in US are ‘inappropriate’
David McNamee writing for Medical News Today reported one third of total knee replacements in the US are “inappropriate” when applied to a Spanish patient classification system, according to a study published in Arthritis & Rheumatology, a journal of the American College of Rheumatology.
Figures from the Agency for Healthcare Research and Quality show that more than 600,000 knee replacements are performed each year in the US. This surgery has become more common, with studies showing a 162% annual volume increase in Medicare-covered knee replacement surgeries during 1991-2010.
Experts are divided on the reasons for this growth, with some maintaining it demonstrates that the procedure is effective, while others argue the surgery is being overused. One concern of the critics who believe total knee arthroplasties (TKA) are being overused is that the procedure “is highly reliant on subjective criteria.”
For the new study, researchers from Virginia Commonwealth University in Richmond examined the criteria that is used to determine appropriateness for TKA.
The authors point out that the investigated criteria have not been studied in the US and have been developed in other countries.
“To my knowledge, ours is the first US study to compare validated appropriateness criteria with actual cases of knee replacement surgery,” says lead author Dr. Daniel Riddle from the Department of Physical Therapy at Virginia Commonwealth University.
Comment: My opinion is that total knees are overdone.
Mary Brophy Marcus writing in HealthDay reported that a new 700 patient study showed that most people returned to work after a total knee replacement, even those with physically demanding jobs. The study presented at the annual meeting of the American Academy of Orthopedic Surgeons in Chicago shows that 98% of people who undergo total knee replacement are able to go back to work afterwards.
So, my comment on this that it’s very encouraging news that shows how much the technology has improved.
Nancy Walsh writing in MedPage Today reported that the reasons for failures of implanted knees have changed over the past 15 years with the majority of failures today relating to surgeon dependent
factors such as component mal-positioning according to research presented at the meeting of the American Academy of Orthopedic Surgeons. Researchers arrived at this conclusion after having conducted a retrospective review of why primary knee implants failed in almost 700 cases and the time frames in which this happened. The study’s lead author said in over 70% of cases where the cause was aseptic loosening, infection, or instability the mechanisms were at least in part under the surgeon’s control.
My comment about this: all the more reason to find a surgeon who specializes in the procedure you’re going to have.