YOU ARE never too old to undergo surgery for a new hip or a new knee. That is the message from research, published this morning, into joint replacement surgery for older people with severe osteoarthritis.
Doctors in the US recruited 174 patients with an average age of 75 years, who had severe "wear and tear" arthritis of the hip or knee. Arthritis symptoms, such as pain and reduced mobility, were assessed at the beginning of the study and again 12 months later. Researchers also looked at the medical decision-making process that led to 51 patients opting for surgery, while 123 people decided not to have a joint operation.
There was a much greater improvement in symptoms in the group that opted for replacement surgery. It took an average of 12 days for the patients to regain the ability to walk independently; the recovery time was similar for patients aged 65 to 74 years and those 75 years or older.
Of some concern was the finding that, among patients who did not have surgery, some 45 per cent said that surgery was not offered as a potential treatment option.
Writing in the current issue of Archives of Internal Medicine, an American Medical Association journal, Dr Mary Beth Hamel and her colleagues from Beth Israel Deaconess Medical Centre in Boston say: "Joint replacement surgery was not offered as a treatment option for many patients, suggesting that some physicians may not provide elderly patients with the opportunity to choose this effective treatment."
They added: "Compared with patients who had surgery, patients who did not have surgery were older, had lower incomes, and were more worried about surgical complications and a long recovery."
Osteoarthritis is the result of "wear and tear" of joints, especially at weight-bearing sites such as the hip and knee. The condition is more common in older people, although previous joint injury can bring forward the onset of inflammation.
It is characterised by pain, joint swelling and a reduced ability to perform daily tasks.
As a result of changing demographics, the number of older people with advanced osteoarthritis is increasing. However, new techniques involving spinal anaesthesia mean it is now routine to replace joints in people in their 80s.
Alternative treatments for mild to moderate osteoarthritis include anti-inflammatories and physiotherapy.