For patients who suffer from osteoarthritis of the knee, total knee replacement is a cost-effective procedure that leads to greater mobility and independent living — even for those in their 80s or 90s — according to research from Duke University Medical Center published in the October issue of Arthritis & Rheumatism.
Researchers found that older patients who received the procedure were twice as likely to show improved physical mobility as those who did not. But because success depends on an intense rehabilitation regimen, doctors are often reluctant to recommend the procedure for patients in their 80s and older despite its physical and economic advantages. The study’s findings could help doctors and patients make more informed decisions when considering the procedure.
Total knee replacement is performed when other forms of treatment have failed and it is considered a routine surgery. However, there has been little evidence demonstrating how the procedure affects patients over age 65.
According to lead author Linda George, Ph.D., associate director of the Duke Center for the Study of Aging, this is the first study to examine the effects of total knee replacement using data from the Medicare Current Beneficiary Survey, a randomly selected group of Medicare beneficiaries aged 65 and older. The Duke researchers looked at 259 patients who received total knee replacement and 1,816 patients who did not.
Patients who received total knee replacement improved over time, but physical functioning declined in those who did not. Patients who were disabled at the time of surgery transitioned out of disability within one year of the procedure.
Reimbursement for the procedure (averaging $4,000 – $6,000)(1) proves less costly than the long-term cost of health care for the disabled, which can include hospital stays, nursing homes and home health care.
The research was supported by a grant from The Institute for Health Technology Studies (InHealth).