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Total Knee Replacement Found Effective

By HospiMedica staff writers
Posted on 05 Jan 2004
After an extensive review of the medical literature and reports from experts in the field, an 11-member panel has found that for people suffering from intractable and persistent knee pain and disability, total knee replacement (TKR) surgery is a safe and cost-effective therapy that restores mobility and alleviates discomfort.

Over 20 years of follow-up data show that the procedure is successful in a majority of patients. More...
However, the panel did note that there are racial, ethnic, and gender disparities but the reasons for these are unclear. Doctors' beliefs about their patients, limited familiarity with the procedure in minority communities, and patient mistrust of the health care system may all play a role. Loosening of the implant is the main cause of failed total knee prostheses that require revision procedures, and the proper alignment of the prosthesis is critical to minimizing long-term wear and loosening of the implant.

The panel included doctors and researchers in orthopedics, rheumatology, internal medicine, nursing, physical therapy, rehabilitation, biostatistics, epidemiology, and health services research. The panel's statement is an independent report, but it was sponsored by the Consensus Development Program of the US National Institute of Health (Bethesda, MD, USA).

"TKR is not for everyone. It's major elective surgery that carries a variety of important risks, but it often offers dramatic relief after other therapies fail,” said the panel chair, orthopedic surgeon Dr. E. Anthony Rankin of Providence Hospital (Washington, DC, USA). The panel also emphasized that important factors to consider when having this surgery is the volume of TKRs performed by the surgeon and by the hospital. Higher volumes are associated with lower complication rates.




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