Patients Rate Knee, Hip Replacement

May 5, 2006 -- A new survey by Consumer Reports shows a high degree of patient satisfaction with knee- or hip-replacement surgery.

The survey included 1,001 knee- and hip-replacement patients. The results, published in the magazine's June issue, include:

• 82% reported being "very" or "completely" satisfied with their new joint.
• Recovery is long and sometimes painful.
• 5% reported getting an infection shortly after surgery, a higher rate than in some other studies.
• Secondary complications were relatively common.

Every year, more than 600,000 people in the U.S. undergo hip- or knee-replacement surgery, according to Consumer Reports. The magazine survey included a nationally representative sample of those patients.

Here is a closer look at the survey and its results.

Who Took Part?

The survey was conducted by telephone in February 2006. Participants had received a new hip, knee, or both knees any time between 2000 and 2004.

"More than 70 percent had the surgery because of osteoarthritisosteoarthritis; other reasons included fractures, traumatic injuries, and rheumatoid arthritisrheumatoid arthritis, a less common form of arthritisarthritis that stems from autoimmune causes," states Consumer Reports.

A third of the patients were men. Patients were about 71 years old, on average; 15% were younger than 60. About 40% got hip replacements and 60% underwent knee replacementknee replacement.

Shoulder replacement and partial knee replacement were not covered in the survey.

Patients' Views of Recovery

The magazine provides these details on the patients' recovery:

• Most patients stopped taking pain medications (including over-the-counter pills) after two months.
• 12% were still taking pain medication after a year.
• At least 90% could do routine activities after a month.
• A third of hip patients and a quarter of knee patients said they couldn't walk half a mile as late as a year after surgery.

As for the 5% of patients who reported infections soon after surgery, "we can't tell from our survey whether those were serious deep-tissue infections or less worrisome surface infections," Consumer Reports states.

Other reported complications included:

• A seriously weakened or contracted muscle (13% of patients).
• Legs of unequal length (13% of hip-replacement patients and 7% of knee-replacement patients).
• Another operation to correct problems from the first surgery (5% of all the patients).

Getting a New Hip or Knee?

Consumer Reports provides these tips for people planning to undergo hip- or knee-replacement surgery:

• Don't wait too long. See your doctor or an orthopaedic surgeon if pain makes it hard to sleep through the night, if routine activities are difficult, or if pain medication doesn't work or has side effects such as stomach bleeding or ulcersulcers, higher blood pressure, fluid retention, or reduced kidney or liver function.
• Lose weight before surgery, if needed. For obese people, losing weight before surgery may help postsurgery recovery.
• Find a qualified surgeon. The magazine's medical consultants suggest looking for surgeons who do at least 50 per year of the procedure you're getting, and for surgeons who specialize in knees and hips (or at least joint specialists).
• Take steps to prevent infection. Precautions include an intravenous dose of antibiotics in the hour before surgery and more antibiotics in the 24 hours after surgery. Clean hands are also important for anyone who touches you.
• Plan for your discharge. Expect to be at least somewhat disabled for the first week or two after surgery.
• Comply with physical therapy. Survey participants who had followed physical therapy instructions were more likely to report better results after knee- and hip-replacement surgery.

SOURCES: Consumer Reports, June 2006; vol 71: pp 15-17. News release, Consumer Reports.