People with knees worn out by arthritis will get more pain relief from joint-replacement surgery, but it has more risks and there’s a good chance that less drastic approaches also would help. That’s the bottom line from the first study to strictly test other treatments against knee replacement, an operation done hundreds of thousands of times a year in the U.S.
“It’s one of the great operations of the 20th century,” yet good evidence of its effectiveness has been lacking, said Dr. Jeffrey Katz, a joint specialist at Brigham and Women’s Hospital in Boston.
He wrote a commentary that appears with the results in Thursday’s New England Journal of Medicine, and he said the right choice will be different for each patient, depending on goals, overall health and whether the person wants to have or avoid surgery.
More than 670,000 total-knee replacements are performed annually in the United States, mostly for arthritis, which deteriorates cartilage in the joints.
Experts advise trying other things before considering surgery, such as weight loss, physical therapy, exercise and medicines, and many studies show these can help. But for how long is not known, nor are there good comparisons of side effects.
