Study: Partial Knee Replacement Safer

Study: Partial Knee Replacement Safer

Patients who have total knee replacement surgery (TKR) are four times more likely to die in the first month after surgery than those who have partial knee replacement, according to a major new study published in the British medical journal The Lancet. The study is one of the first to compare the risks and benefits of both types of knee replacement surgeries.

Researchers at the University of Oxford analyzed the outcomes of over 100,000 knee replacement surgeries and found that – while the risk of serious complications is small — TKR patients are twice as likely to have a blood clot, heart attack or deep infection, three times as likely to have a stroke, and four times as likely to need blood transfusions, compared to those having partial knee replacement.

PTG_P“This is a comprehensive study that provides both patients and surgeons with valuable information about the risk and benefits of two effective types of knee replacement operations. This new knowledge will enable them to make an informed decision about which type of surgery is best for particular individuals,” said Professor Alan Silman, medical director of Arthritis Research UK, which helped fund the study.

“These data remind us that there are still patients, who fortunately very rarely, can develop life threatening complications following surgery and we still need to find surgical approaches that takes away these risks while retaining a successful outcome for patients.”

While partial replacement surgery was found to be safer and with fewer complications, patients who have the procedure are 40% more likely to need another operation, known as revision surgery, during the first eight years after the replacement, than those that had a total knee replacement.

“For an individual patient, the decision whether to have a partial or total is based on an assessment of the relative risks and benefits. The main benefit of the partial knee is that it provides better function,” said lead researcher Professor David Murray, from the Nuffield Departmental of Orthopedics, Rheumatology and Musculoskeletal Sciences at the University of Oxford.

“To put the risks in perspective, if 100 patients had a partial knee rather than a total knee replacement there would be one fewer death and three more re-operations in the first four years after surgery.”

Over 600,000 knee replacements are performed annually in the U.S. and over 76,000 in the UK. Osteoarthritis, a degenerative joint disease that causes pain and swelling, is the leading reason why people elect to have the surgery.

During TKR surgery, doctors replace the entire joint with metal or plastic components that allow for continued motion of the knee. During partial replacements, also known as unicompartmental replacements (UKR), only the diseased or damaged parts of the knee are replaced and the remaining surfaces and ligaments are preserved.

“Partial and total knee replacements are both successful treatments and a large proportion of patients with end-stage knee osteoarthritis are suitable for either,” said Alex Liddle, a clinical research fellow at Arthritis Research UK. “Both have advantages and disadvantages, and the choice of which procedure to offer will depend on the requirements and expectations of individual patient.”

The number of knee replacement surgeries in the U.S. and UK has soared in recent years as their populations have aged. Knee osteoarthritis is more prevalent and severe in the elderly, women, and the obese.

But some experts believe the procedure is over-utilized and too often recommended by doctors.

A study published last month in the journal Arthritis & Rheumatology found that over a third of the total knee replacements in the U.S. are inappropriate. Researchers found that many patients had knee pain and other symptoms that were too mild to justify having the surgery.

Authored by: Pat Anson, Editor

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Kathleen Brill

I had a partial replacement in 2004. I did everything I was told to do, including walking at the target store daily 4 times around the tiled area. in a week I had to go back, The Doctor was amazed that I was ready to go back to work, no swelling and I had a full range of motion. today I have zero problems. The difference 1) The doctor measured several times. cut once 2) I did every exercise and iced my knee as instructed. 3) Still to this day I do knee exercise to support the knee. If you don’t do the work you will not have a good result, but you need a great doctor! check them out!!!

This is a catch 22 for everyone who are in our healthcare system and have no financial wherewithal to get treatment outside of the system. This situation was set up by prestigious specialist because specialist know better than primary care and general providers. The specialist know that to be efficient they need a fast track to the most effective high technology treatments. The fast track makes sense for cancer, tumors and infections which are “structural” diseases of the body that are removed and the patient is restored back to health. The patients win, specialist win, the insurance companies win, the lawyers win and everyone is happy.

This formula does not work for non-structural problems that are not seen by technology. This non-structrual pain is in the muscles, tendons and ligaments and begins as aches, pains and stiffness; this type of pain will grow and lead to secondary problems which are neuropathy, pinched nerves, poor circulation, compression damage to the joints and discs; it will continue to grow and spread deeper into the tissues and lead to tertiary damage of metabolic, immune and chemical malfunctioning.

The catch-22 choices are paradoxes in the AMA and Insurance industry regulations between the least desirable surgeries (brain, nerve, joint or spine) and no effective treatments. No treatment means; no access to Chiropractors, Active Tissue Release, Acupuncture, GunnIMS, dry/wet needling, Travell Injections, Prolo or Biopuncture. All these are grouped under the disciple of Myofascial (MF) Therapy with hands-on and with needles. There are researchers in this CAM field who are discovering that damaged joint structures will rejuvenate with this therapy. They are also studying the effects of Stem Cell therapy to reverse the damage too.

This catch-22 is not in the patients best interest but because of marketing and deceptions the patient is lead to believe that is the best of the best care and will go along in the blind. But some will seek out alternatives and those who do still have to overcome a few more barriers; Out of pocket costs, naysayers who disparage these alternatives, poorly and incompletely trained providers and internal fears. Also CAM providers are human and fall victim to the same for-profit business models, ethical lapses and flawed logic as do Traditional Medical providers. So watch out!

To protect yourself if you are in this situation, ask your specialist about ALL options from ALL aspects of medicine. Make sure that the consent form you sign for joint replacement, brain surgery or back surgery states that you have failed ALL of the above MF treatment options within a year or two. If a patient is given ALL options, I’m certain that the vast majority of people would want to keep their God given parts.

I think by now you all know my stance on this therapy; “MF release therapy is the best medicine in medicine.”