Knee Replacement Surgery Often Delayed Too Long, Increasing Risk of Complications: Study

A new study suggests that most individuals who need a knee replacement surgery wait far too long, opening themselves up to an increased risk of problems and complications.

Researchers from Northwestern University’s Feinberg School of Medicine report that roughly 90% of patients who have osteoarthritis and would benefit from knee replacement surgery, yet they often delay the surgery, which increases the risk of weight gain, loss of function, depression and other problems that may decrease the later benefits provided by the procedure.

In findings published this week in the Journal of Bone and Joint Surgery, researchers analyzed data from two multi-center cohort studies, focusing on information involving 3,400 patients who had osteoarthritis or were at risk for experiencing knee osteoarthritis. Of those, 2,300 were eligible for replacement surgery, but only 1,000 people actually had the surgery. Patients were followed up for eight years.

Overall, researchers found up to nine out of ten patients would benefit from having the surgery, but are waiting too long to have knee replacement surgery. This affected their mobility, activity levels, overall health, weight gain, and can lead to mental health problems including depression. The study notes 42% of those patients had severe symptoms.

Patients who have surgery when their function is too far deteriorated still improve a lot, but the improvement is not to the level they would experience if they had not delayed the knee replacement, the researchers determined.

Conversely, about 26% of people who choose to have knee replacement surgery are getting it too early, according to the researchers. This can lead to increased risk of complications, incur unnecessary costs, and they may not get as much benefit. Knee replacement surgery can cost $12,000 to $70,000.

Additionally, artificial knees wear out after about 20 years, so if you have it replaced too early, you will need another surgery later in life, which can be more difficult when you are older.

Researchers said roughly 8% of the total patients were categorized in the “timely” group and received the surgery when they needed it.

Black patients were more likely to need the surgery but not have it, while patients who were more likely to have premature surgery that wasn’t needed were people with depression and those with a body mass index greater than 25.

More than 1 million knee replacement surgeries occur in the U.S. each year.