Only a fraction of older Americans with arthritic knees try physical therapy, pain relief injections, or other more conservative measures before undergoing knee replacement surgery, according to new research.
And this may be determined by the type of doctor they see to treat their painful knees and where they live, according to the results of the study.
Osteoarthritis of the knee occurs when the cartilage between the bones ruptures, causing pain, stiffness, and swelling. The risk of knee arthritis increases with old age, overweight and the presence of old knee injuries, among other factors, according to the Arthritis Foundation.
“Most people over the age of 65 with osteoarthritis of the knee having a knee replacement without having previously had physiotherapy or a visit to a non-surgical specialist, such as a rheumatologist, “said the study’s author, Dr. Michael Ward. He is a rheumatologist at the National Institutes of Health. Arthritis and Musculoskeletal and Skin Diseases in the USA.
“Conservative care should be used first in cases,” Ward said. “Exercise i weight loss in overweight people it can be very helpful in decreasing knee pain and improving mobility. “
Non-surgical specialists can also provide them steroid injections which can help with pain and swelling, or with injections of hyaluronic acid to lubricate the knee joint, reducing pain and improving mobility, he added.
Surgery should always be the last resort, as it confers its proportion of complications, including infection. “Always ask if there are other treatments that should be tried first if your doctor recommends early surgery,” Ward suggested.
Dr. David Pisetsky agreed. He is a professor of medicine at Duke University School of Medicine in Durham, NC
“The trend is to focus on surgery, but it can be done long before surgery to reduce the need for surgery,” said Pisetsky, who did not participate in the new research. If you lose weight, knee pain not only improves, but if or when you have surgery, the results are usually better, he noted.
And a lot of people are also very happy with joint injections. “They don’t want surgery and they can get relief from these injections,” Pisetsky explained.
In the study, Ward analyzed insurance claims of more than 988,000 Medicare beneficiaries in the United States who suffered from osteoarthritis of the knee between 2005 and 2010. The information examined included rates of visits to physicians, physiotherapy, knee injections, and / or other procedures until patients went having a knee replacement surgery or study ended in 2015.
Just over 33% of patients had knee replacement surgery during the study period. Some parts of the United States, including the upper Midwest and Mountain West regions, had higher rates of knee replacement surgery, while other regions had much lower rates, Ward found.
Surgery was more common in people who often complained to their knee pain doctor. Those who tried physical therapy, saw non-surgical specialists (such as physiotherapists, rheumatologists, or pain specialists) or injections received were less likely to undergo knee replacement surgery, the study was found. This could be due to the desire to avoid surgery rather than improve pain, Ward noted.
The study was recently published in the online journal Arthritis and rheumatology.
The Arthritis Foundation has more information on knee osteoarthritis, including its causes and treatments.
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Citation: Many Elderly Americans May Need Better Care for Knee Arthritis (2021, June 15), Retrieved June 15, 2021 at https://medicalxpress.com/news/2021-06-seniors-knee -arthritis.html
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