Study: 1/3 of knee replacements are questionable
June 30th, 2014
03:34 PM ET

Study: 1/3 of knee replacements are questionable

Whether to replace aging knees can be a tough decision. More than 650,000 Americans underwent total knee replacement surgery last year, but a new paper from researchers at Virginia Commonwealth University suggests that a third of those were not “appropriate,” based on standard medical criteria.

The study authors analyzed 175 cases, looking at imaging tests to find the degree of arthritis, as well as each patient’s age and reported pain level. Only 44% of the operations were rated “appropriate.” Thirty-four percent were “inappropriate,” while 22% were inconclusive.

But appropriateness is in the eye of the beholder, says Dr. Jeffery Katz, an orthopedic surgeon at Brigham and Women’s Hospital in Boston. When the current criteria were developed in the late 1990s, knee replacement “was considered a treatment of last resort,” Katz writes in an editorial published alongside the study in the Journal of Arthritis and Rheumatism. Today, many are being done in relatively healthy people in their 50s and 60s.

Is fake knee surgery as good as the real thing?

What’s more, some doctors say, safety and effectiveness have improved significantly since the criteria were first developed.

“Knee replacement is very effective,” says Dr. Joshua Jacobs, an orthopedic surgeon at Rush University Medical Center and a former president of the American Academy of Orthopaedic Surgeons. “The increasing demand is a marker of how well it improves function and relieves pain.”

Whether knee replacement should be used to preserve function and not just restore it “is worthy of debate,” says Dr. Daniel Riddle, the paper’s lead author and a professor in the Department of Physical Therapy and Orthopedic Surgery at VCU. “Some patients play nine holes of golf and they want to play 18, and knee replacement can help with that.”

He says the real question is whether it’s worth the cost – which typically runs between $20,000 and $40,000 – and the potential risks.

A knee replacement is major surgery; potential dangers include infection, deep vein thrombosis and pulmonary embolism. There’s even a non-negligible chance of death, although it’s less than 0.5%, according to the paper.

With younger patients, other factors come into play. Those who undergo the operation early are more likely to achieve a high level of function than patients who wait for their knees to deteriorate. New knees can also help support a higher level of activity and the health benefits that go with it. One analysis cited by Jacobs says there’s a typical lifetime benefit of $10,000 to $30,000 due to lower absenteeism, better overall health and other factors.

On the other hand, anyone getting a knee replacement in their 50s or 60s has a good chance of experiencing a re-run: approximately 10% wear out within 15 years and need to be replaced again, says Riddle.

For more, check out the American Academy of Orthopaedic Surgeons' guide for patients.

soundoff (166 Responses)
  1. J-dog

    it's stupid to replace the knee of a person that's has been overweight and/or negligent their whole life. We get old, you won't feel like you are 20 forever. If you have the money to pay for it, more power to you. Expecting taxpayers to pay for your 25 doughnut a day habit is retarded.

    July 3, 2014 at 00:19 | Report abuse | Reply
  2. Paul

    Meniscus surgery is certainly needed in cases of Grade III tears or significant fraying of the cartilage. One must explore all options particular to the individual's lifestyle. Reference good learning resources such as the National Library of Medicine or AidMyMeniscus

    July 3, 2014 at 12:25 | Report abuse | Reply
  3. portlandtony

    "On the other hand, anyone getting a knee replacement in their 50s or 60s has a good chance of experiencing a re-run: approximately 10% wear out within 15 years and need to be replaced again, says Riddle."
    You'll probably not gonna need a knee if you get it replaced in your mid to late 60's. LOL

    July 10, 2014 at 18:39 | Report abuse | Reply
  4. fernace

    Yeah, @ J-dog, if you're 50lbs overweight knees will give out, even if you're younger! We're such a surgery happy nation, w/ all the cosmetic surgeries, I think many people view knee/hip replacements as kinda the same thing! Eating healthy, moderate exercise, losing weight are still the best ways to ensure we don't need replacement parts!!

    July 13, 2014 at 16:28 | Report abuse | Reply
    • kathycarreldridge

      There are other reasons, a former injury, scoliosis which causes your knees to wear unevenly, and other deformities . Don't judge unless you know all the facts.

      August 14, 2014 at 20:24 | Report abuse |
  5. Matt Whitehead

    I think the most important thing that is not being talked about is why do people develop osteoarthritis in the first place? It is not complicated and even the NIH in 2010 published a study on why people develop it and what makes it worse. You can read about it here: http://www.oregonexercisetherapy.com/blog/knee-joint-osteoarthritis
    The second factor to discuss is why do knee replacements fail after 10-15 years? And why do some fail much quicker than others (same manufacturer and doctor but different patients)? I talk about this subject in an article here: http://www.oregonexercisetherapy.com/blog/why-joints-fail-and-how-to-prevent-it

    July 14, 2014 at 12:41 | Report abuse | Reply
  6. Hermes Birkin Crocodile Bag Replica

    hermes italia More Support
    Hermes Birkin Crocodile Bag Replica http://manshoor.iki.ac.ir/maad/config/cheap-hermes-bags-replica-birkin-tasche-online-9-3.asp

    September 23, 2014 at 10:20 | Report abuse | Reply
  7. Emmett Vanhevel

    pomoc zadluzonym


    August 3, 2016 at 13:58 | Report abuse | Reply
  8. Jack Terrian

    click here


    September 10, 2016 at 15:41 | Report abuse | Reply
  9. Xavier Varn

    Estate agents aldershot Hampshire


    September 29, 2016 at 11:11 | Report abuse | Reply
  10. Eliseo Fabela

    After I originally commented I clicked the -Notify me when new feedback are added- checkbox and now every time a remark is added I get four emails with the same comment. Is there any method you possibly can take away me from that service? Thanks!


    September 29, 2016 at 20:14 | Report abuse | Reply
  11. Carolann Puffett

    Free slots


    January 18, 2017 at 03:27 | Report abuse | Reply
  12. Juli Zientek

    Hello there, You have done a great job. I’ll definitely digg it and personally recommend to my friends. I am confident they'll be benefited from this site.


    January 19, 2017 at 23:49 | Report abuse | Reply
  13. Paddle App

    Gosh I hope I make it through life without getting a knee replacement. Finding the right doctor to do these surgeries is key you must shop around .

    June 7, 2017 at 17:45 | Report abuse | Reply
  14. technology adviser

    amazing post, thanks a lot. On a scale from 1 to 10, You are an 11.


    August 30, 2017 at 17:55 | Report abuse | Reply
  15. investor adviser

    I just randomly discovered your website. Take a look at my web site as well and let me know what you think.


    August 31, 2017 at 15:17 | Report abuse | Reply
  16. investor adviser

    I enjoyed your blog. I am trying to learn more on this topic. Your points are well formed.


    September 1, 2017 at 16:19 | Report abuse | Reply
  17. Sheldon Owen

    I am bored to death at work so I decided to browse your blog on my iphone during lunch break. Is there anything else I could read to learn more about this? I am hoping you write once more very soon! Any team would be lucky to have you on it.


    September 1, 2017 at 20:43 | Report abuse | Reply
  18. technology adviser

    You have opened my eyes to varying views on this topic with interesting and solid content. It is really unbelievable you do not have a larger following. Right here is some really useful info.


    September 4, 2017 at 16:56 | Report abuse | Reply
  19. Jesse Grillo

    I have added your blog to my LinkedIn You saved me a lot of hassle just now. Spot on with this posts. I really like your blogs. I love your write ups but... I do not read well. Do you have Youtube videos on the subject?


    September 5, 2017 at 15:05 | Report abuse | Reply
  20. MichaelPouch

    Nike Air Force White Sk
    Keep the video camera clean and set aside when not being utilised if you would like ensure that it usually usually takes the best photographs achievable. You can find sensitive elements inside of quality video cameras that may come to be very easily destroyed as a result of trembling and even something similar to substantial moisture. Make your video camera risk-free and put out when you're not snapping pictures.


    Figure out how to really like whole wheat lawn provided you can. Commence your wheat or grain grass partnership off of very gradually since it is an exceptionally powerful flavorful vegetation. The source of nourishment advantages are out of this community however some men and women think the flavors is just as well. Use strongly flavored fruits and small amounts of wheatgrass and job towards you up to greater sums over time.


    September 21, 2017 at 03:28 | Report abuse | Reply

    Seeking for effective, quick and fast natural herbs rememdy to cure herpes contact: ehiagwinaherbalhome@gmail.com

    December 12, 2017 at 12:11 | Report abuse | Reply
  22. GbeduJamz

    Okay thanks for the post

    January 6, 2018 at 07:49 | Report abuse | Reply
  23. Bobbie Kosiorek

    It really is good to get the opportunity to read an excellent quality short article with helpful details on topics that loads are interested on.I concur along with your conclusions and can eagerly search forward to your future updates.


    January 20, 2018 at 08:39 | Report abuse | Reply
  24. Jenee

    Thanks for expressing these types of amazing strings.


    April 12, 2018 at 05:10 | Report abuse | Reply
  25. Melodygist


    July 30, 2019 at 03:38 | Report abuse | Reply
  26. Teresa

    If you wish for to increase your know-how only keep visiting this website and be updated with the latest information posted here.

    my site; slot online

    November 30, 2020 at 16:22 | Report abuse | Reply
  27. slot games

    Best view i have ever seen !


    December 4, 2020 at 19:10 | Report abuse | Reply
  28. free spin slots

    Best view i have ever seen !


    December 4, 2020 at 22:16 | Report abuse | Reply
  29. how much does a lamborghini windshield cost

    lamborghini i am a winner


    December 9, 2020 at 09:36 | Report abuse | Reply
  30. BTCC 1999

    Win a Rolex or $15,000 in Free BTC http://freebitco.in/?r=14268596&tag=11122020


    December 11, 2020 at 07:40 | Report abuse | Reply
  31. Rolland Pettrey

    I am just starting out and want to get a blog started..


    December 29, 2020 at 16:34 | Report abuse | Reply
  32. baccarat

    Best view i have ever seen !


    January 5, 2021 at 14:02 | Report abuse | Reply
  33. 온라인 바카라

    Best view i have ever seen !


    January 5, 2021 at 14:02 | Report abuse | Reply
  34. face masks

    This brings up some insightful ideas-however I believe you might be missing something. I hope to see you expand this, because you are a worthy author and I enjoy reading your posts.


    January 6, 2021 at 03:54 | Report abuse | Reply
  35. Kennethculty

    Nice to see you.. Maid service at home and Spring Cleaning the specialized company more than 5 years. We are working with various clients : car dealers, cultural and entertainment establishments. We produce clean up Snow removal. We guarantee compliance required deadlines and protection real estate. You can order of a specialized company remove Dry cleaning of carpets,Housemaid and Spring Cleaning. Our specialized international company individually for each client and calculating for cleaning proceeding from area housing. 15-year-old experience in such areas as cleaning intended Maid service in my area calculate probable obstacles , which arise in progress Tidying up Cleaning and cleaning services and Best spring cleaning and Housemaid luxury cottages , premises . By resorting to current industrial equipment and professional cleaning products, Home maid clean and Best spring cleaning getting ideal results and happy cleaning as, for example, in city and country townhouses and cottages. Offers our firm profitable those who highly appreciates their time and absolutely not intends to to lose it on tidy up Cleaning lady. Call up or write to our mail , in order find out cost and order Cleaning Internal cleaning of furniture, Housekeeping maid service, Best spring cleaning and Housemaid.

    In property cleaning company – ideal Maids service Nyc
    – it's effortless, hassle-free as well as economical with our business.
    Rely on the cleanliness innovators to house cleaning Brooklyn! Our company utilize expert cleaning agents and technical devices of international suppliers in our work and carry out a great project with cleaning of any complexity.

    Collaboration along with the company is actually the guarantor of an impressive, rewarding as well as dependable cleansing of expert home cleansing and also surrounding areas. Currently, home cleaning company from our business are used in New Jersey. Value as well as you the true advantages as well as efficient benefits of our company proposition.
    Through authorizing a long-lasting company arrangement with us, you are going to manage to leave the requirement to maintain a large team of technical staff, which, consequently, will optimize expenses. The price of the complex, daily, standard house cleansing of Staten Isle, conducted by our workers, will definitely consistently be actually less than the expense of incomes for cleaning services, the acquisition of cleansing products as well as equipment.
    Leave behind an ask for on the web site, define your name or even firm label, call contact number and time of desired cleaning, leave your wishes and needs in a message to the manager if required, then our expert is going to contact you in the least time and point out the time, time and also place of work!

    January 8, 2021 at 01:01 | Report abuse | Reply
  36. JoshuapudgE

    http://wsec.org.za/women-as-role-players-guardians-of-food-knowledge/#comment-8354 – Hydromassage NY
    We greet you! Our employees firms those who make your privacy life easier. Organization that active more than 15 years.

    http://sandiegobookreview.com/tomorrow-war-the-chronicles-of-max-redacted/#comment-1030367 – Hot Stone NY
    Distinctive unusuality our Anticellulite salon is not an enforced setting. We promote social profiles to create.
    https://lubbockbgc.org/at-some-point/#comment-4048 – thai NY
    We can offer for you check very different type massage methods today. Employees of our company waiting you in our SPA.
    https://www.architectlaos.com/2018/04/05/hello-world/#comment-12945 – Reiki New Yourk

    January 8, 2021 at 09:45 | Report abuse | Reply
  37. best face masks

    This post could include so much more 🙁 You should write more about it soon?


    January 9, 2021 at 07:10 | Report abuse | Reply
  38. face mask

    Nice piece – we need to see more like this, because most info about this topic is generalized. You provide real worth to your readers.


    January 9, 2021 at 07:26 | Report abuse | Reply
  39. Pedro Dufek

    I enjoy you because of every one of your hard work on this web page. Gloria really loves managing internet research and it is easy to see why. Almost all notice all of the powerful means you give rewarding suggestions via the blog and as well as strongly encourage contribution from other people about this content and our own girl is learning so much. Enjoy the remaining portion of the year. Your conducting a glorious job.


    January 10, 2021 at 06:37 | Report abuse | Reply
  40. Weldon Lubben

    When the mermaid spreads Baba's legs to the platoon, the regimental mare is easier. Warning shot in the head Heromantia is the name of the condom in ancient Greece. If you want to make friends, make them far away. Ivan Susanin. And they lived long and often. The gap justifies the means. Love at first sight


    January 13, 2021 at 05:26 | Report abuse | Reply
  41. n95 face masks

    This is timely for mygang on Twitter-sharing!


    January 14, 2021 at 07:52 | Report abuse | Reply
  42. n95 face masks

    I 'm pretty sure that you could be bang on with this.


    January 14, 2021 at 08:11 | Report abuse | Reply
  43. face masks

    Don't ever quit trying. Succeed!


    January 20, 2021 at 19:38 | Report abuse | Reply
  44. best face masks

    Want to share more concerning this topic? I know you're downplaying some of your polarized musings, but I would certainly love reading them..


    January 20, 2021 at 20:28 | Report abuse | Reply
  45. Reinaldo Kanno


    January 21, 2021 at 05:52 | Report abuse | Reply
  46. Robby Hallstead

    And really creative ... super!


    January 24, 2021 at 02:18 | Report abuse | Reply
  47. Jimmy Tuite


    January 26, 2021 at 17:33 | Report abuse | Reply
  48. bola online

    I believe this is one of the such a lot important information for
    me. And i'm satisfied reading your article.
    However want to remark on few normal things, The
    web site taste is wonderful, the articles is actually nice : D.
    Just right process, cheers

    January 27, 2021 at 00:03 | Report abuse | Reply
  49. Carmon Deaner


    January 27, 2021 at 02:40 | Report abuse | Reply
  50. 무료 스핀 슬롯

    This is something New !


    January 28, 2021 at 04:06 | Report abuse | Reply
1 2 3 4

Leave a Reply to https://topphimhot.net


CNN welcomes a lively and courteous discussion as long as you follow the Rules of Conduct set forth in our Terms of Service. Comments are not pre-screened before they post. You agree that anything you post may be used, along with your name and profile picture, in accordance with our Privacy Policy and the license you have granted pursuant to our Terms of Service.

About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.