Total joint replacements for osteoarthritis are more effective before the person is debilitated, according to the results of a prospective cohort study published in the December issue of Arthritis & Rheumatism.
“Although there are no validated indications for when a patient should optimally have joint replacement, these data suggest that timing of surgery may be more important than previously realized and, specifically, that performing surgery earlier in the course of functional decline may be associated with better outcome,” write Paul R. Fortin, MD, MPH, FRCPC, from the University of Toronto in Ontario, Canada, and colleagues.
Of 222 patients with osteoarthritis undergoing total hip or knee replacement, 165 (74%) remained in the study after two years. Based on preoperative Western Ontario and McMaster Universities Osteoarthritis Index function score, physical function subscale, pain subscale, and function subscale scores, subjects were divided in two groups. The group with the worst function and pain at baseline had comparatively worse function than the higher-functioning group at six months and at two years after surgery.
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