Patient dissatisfaction following total knee replacement is a growing concern. An article appearing in the November issue of the Bone and Joint Journal focused on a questionnaire in the United Kingdom attempted to quantify the degree of patient satisfaction and residual symptoms following knee replacements. I decided to focus on this subject after having completed a consultation for a 70 year old woman who four years ago, had undergone a bilateral total knee replacement that went on to fail in 24 months. She then underwent a bilateral revision or repeat total knee replacement and is left with inability to fully straighten either side or bend the right and left knee more than 80 degrees. She is severely handicapped. I don’t know what her arthritic impairment had been prior to the original surgery but there really isn’t much to offer her now. What an awful situation.

The article to which I alluded above reports that somewhere between 35 to 54% of those surveyed reported residual symptoms and functional problems and general dissatisfaction. Those who regularly read my Blog might remember a similar result that I reported about in a Canadian survey of patients who had undergone Total Knee Replacement five years earlier. In the current study, neither the use of contemporary prosthetic designs or custom cutting guides improved patient perceived outcomes. The data clearly shows a degree of dissatisfaction and residual symptoms following Total Knee Replacement and those recent modifications in implant design and surgical technique have not improved the current situation

Activity Levels and Functional Outcomes of Young Patients Undergoing Total Hip Arthroplasty

In yet another journal reviewing Hip Replacement Outcomes, appearing  this month in Orthopedics, patient dissatisfaction described greater hip symptoms and poorer hip-related quality of life in those under age 50 undergoing Total Hip Replacement than anticipated. It only makes sense to postpone a joint replacement until there is advanced arthritic impairment. Until then, our evidence in the laboratory and in the office clearly document that Bone Marrow Aspirate Concentrate has the potential to relieve pain, improve function, increase motion, and alter the actual molecular progress of the arthritic process.

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