Knee Replacement Surgery:Study Questions Efficacy and Safety

  Knee Replacement Surgery: New Study Questions Efficacy and Safety

The number of people undergoing total knee replacements in the United States is increasing due to an obesity epidemic and an aging population.  In 2008, more than 650,000 Americans had knee replacements and it cost the U.S. Health Care System $10.4 billion dollars.  Recently, new concerns about knee replacement surgery were just released online in The Lancet.  Dr. Andrew Carr, an orthopedic surgeon, at the University of Oxford Department of Orthopedics, Rheumatology, and Musculoskeletal Sciences and lead researcher found that there is not enough research supporting the effectiveness or safety for the prosthetics used in total knee replacement surgery. 

It’s unfortunate but the FDA (the Food and Drug Administration) doesn’t really scrutinize knee replacements and the manufacturers of knee prosthetics.  A report from the Institute of Medicine in 2011 stated that medical devices have long lacked testing to ensure their safety and effectiveness.  Studies for knee replacements that are available are typically small and are conducted by surgeons that have invented the knee implant, or who were hired by the implants manufacturer.  Therefore, the studies are often biased with there being an obvious conflict of interest.  Dr. Carr stated that, “Without high quality, unbiased and reliable information surgeons cannot make informed decisions.” And due to the recent rise in the number of people getting total knee replacements Dr. Carr along with millions of other Americans think that the FDA should get tougher on these manufacturers. “In the past 40 years the number of implants available on the market has substantially proliferated, often with little or no evidence of effectiveness or cost effectiveness”, Dr. Carr remarked in a statement.

At this point the only way the medical community knows if there is a problem with a prosthetic is if the patient receives a surgical revision.  So rather than testing the implant properly prior to using it on patients, the patient virtually becomes the guinea pig.  So Dr. Carr and his colleagues are asking for stricter guidelines and “surveillance” of knee replacements. He suggests that knee replacements be treated like medications and that there should be large double blind randomized studies and a registry for implants so that their effectiveness can be tracked.  He also commented on the ‘newer implants’ that have come on the market, “…new joint implants may, in fact, be more prone to revision rather then less.”

In addition, during their research, Dr. Carr and his colleagues found that many patients were receiving total knee replacements when they only complained of mild knee pain, and that he believed there should be stricter guidelines for doctor’s to follow when recommending surgery.  Dr. Carr also suggests that patients receiving a total knee replacement should have pain in their knees when they are weight bearing and complain of having pain at night.  They should have also completed at least six months of conservative therapy and not have responded to it before any knee surgery is recommended.

Dr. Carr and his colleagues are not convinced that total knee replacements provide enough pain relief and really hold up to years of wear and tear.  Dr. Carr believes that other non-surgical knee treatment methods should be researched to help patient’s avoid knee surgery in the future.

Dr. Alexandra K. Schnee, D.C. is an author, researcher and Dallas Cold Laser Knee Doctor.  She practices at the DFW Spine and Joint Center in Irving, Texas and specializes in cold laser therapy for knee pain.  Dr. Schnee has developed cold laser knee treatment protocols that she uses as part of her Cold Laser Knee Program™.  Since 2001, she’s helped hundreds of patients avoid unnecessary knee replacements. If you’d like to find out about her non-surgical program please visit http://www.HelpMyKneePain.com or to contact Dr. Schnee please call 214-596-1051.

Knee Replacement Surgery: Study Questions Efficacy and Safety

New study questions the efficacy and safety of knee replacement surgery. Dr. Schnee provides non-surgical cold laser therapy for knee pain in Dallas-Fort Worth, TX.

Primary Source: The Lancet

Carr A, et al “Knee Replacement” Lancet 2012: DOI: 10.1016/S0140-6736(11)60752-6.