Wednesday, March 27, 2013

Only about half of people who have a knee or hip replaced see meaningful improvements in pain and disability in the months after surgery, a new study from Canada suggests.

” More than one million people in the U.S. have a knee or hip replaced each year, researchers said – a rate that’s expected to continue to grow.

Including hospital fees and the parts themselves, the procedures cost $36,000 to $45,000 and are typically covered by insurance.

Despite the rising popularity of joint replacement, uncertainty remains about which patients have the most to gain and who fares best post-surgery. A team led by Dr. Gillian Hawker from the University of Toronto tracked about 2,400 older adults with osteoarthritis or inflammatory arthritis in Ontario, Canada, to see who went on to get surgery and how they did.

From the start of the study in 1996 through early 2011, 479 of them had a knee or hip replaced, including 202 who underwent elective surgery and had before and after pain and disability information available for analysis. By a year or two after surgery, the average person had a 10-point improvement in pain and disability from a pre-surgery score of 46.5 out of 100, the research team wrote in Arthritis and Rheumatism. A nine-point improvement is considered the “minimal important difference” in symptoms, and about 54 percent of joint-replacement patients hit that target.

What about improvement after stem cell intervention?  I have been addressing this question with my most recent blogs. What I refuse to do is promise what I can’t deliver and several patients have chosen to seek out those who promise what cannot be certain. This is what I know is a realistic goal following stem cell intervention for arthritis in descending order:

1)      Pain Relief

2)      Increased Range of Joint Motion

3)      Improved quality of life and functional capacity

4)      Delay and possibly avoidance of a joint replacement

5)      Restoration of joint function

6)      Regeneration of cartilage-maybe, as the potential diminishes with age. How you respond will be documented by an MRI 18 months following Bone Marrow Aspiration Concentrate procedure

It is my job to educate the patient and not guarantee that which is not possible. Remember, I spent 40 professional years inside the joint as part of the treatment of a painful joint.

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