A study of patients undergoing total knee arthroplasty, known in layman’s terms as total knee replacement, has revealed that patients often develop psychosocial problems that lead to never fully recovering. Among those problems are depression, anxiety, persistent pain, and sleeping disturbances.
Findings from the study are very important given the increasing number of seniors undergoing total knee arthroplasty as a treatment for osteoarthritis. One of the study’s co-authors, Dr. Inna Belfer, says that “treating osteoarthritis with total knee arthroplasty is expensive and painful, and in many cases patients do not get better because their chronic pain persists.”
Stop one minute and let that sink in. Belfer and her team are suggesting that total knee replacement surgery intended to relieve the chronic pain of osteoarthritis is not doing that for a growing number of patients. Those patients get completely new knees but still stuffer persistent pain – in addition to the other psychosocial issues already mentioned. How is that a good deal?
No Answers Yet
Belfer’s research took place at the University of Pittsburgh Medical Center with the participation of 153 adult patients with an average age of 64. Each of the patients underwent a total knee arthroplasty procedure. Prior to surgery, the patients completed a series of five questionnaires designed to gauge their psychosocial state. The questionnaires dug into issues like depression and anxiety, perceived stress, current symptoms, and pain level.
Patient pain was assessed at baseline and then six months after surgery. Data showed that 88% of the patients reported moderate to severe pain prior to surgery while 24% reported the same level of pain at six months. Despite the discrepancy, there are no clear answers as to why. Researchers crunched the data and surmised that there is a correlation between continued post-surgical pain and a patient’s psychosocial state before and after surgery.
If that link can be established through future studies, it would indicate that surgeons and primary care physicians should be working together prior to total knee arthroplasty to determine a patient’s psychosocial state. A less than optimal assessment may indicate a patient is not a good candidate for knee replacement. Alternatively, the orthopedic community could look for ways to improve a patient’s psychosocial state so as to allow for surgery.
There Is Another Way
Utah-based Advanced Regenerative Medicine Institute (ARMI) says there is another way to treat chronic osteoarthritis pain in patients who are not good candidates for surgery. That way is regenerative medicine, something that ARMI teaches doctors and surgeons who want to add it to their practices.
Regenerative medicine utilizes platelet-rich plasma (PRP) and stem cell therapies to treat osteoarthritis and its subsequent pain by encouraging the body to fix what is broken. PRP contains several different growth factors along with vital nutrients the body needs to self-repair. Stem cells can be encouraged to grow into new tissue to replace what has been lost in the affected joint.
Advanced Regenerative Medicine Institute is clear that PRP and stem cell therapies are not right for every patient suffering from osteoarthritis and chronic pain. By the same token, surgery is not the right solution for every patient either. Some will benefit from one, some will benefit from the other. The idea is to not assume that every osteoarthritis patient will automatically benefit from total knee replacement.
It is unfortunate that a growing number of osteoarthritis patients are undergoing total knee arthroplasty and still finding no relief. For them, there’s not much to be done once a knee has been replaced. But there is hope for others who have not yet undergone surgery. That hope is regenerative medicine.