title: When should we do knee replacements?
abstract: It is not known whether it is better to perform total knee replacements early or late in the course of arthritis. To examine the determinants of patient-related outcomes after knee replacement, we examined 812 patients in the Avon knee registry, in whom pre-operative and 5-year post-operative American Knee Society Scores were available. Ninety percent had a good outcome at 5 years. Women had significantly more severe disease at the time of surgery than men. Older people (>79 years) had the worst disease at the time of surgery, and made the least health gain, although their overall outcomes were still good. Those with the most severe disease at the time of operation made greater gains to those with less disease, but remained in worse health at 5 years, suggesting that earlier surgery may be preferable.
authors.affiliation: MRC Health Services Research Collaboration, Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK.
authors.forename: L Gail
authors.initials: LG
authors.lastname: Kennedy
authors.forename: John H
authors.initials: JH
authors.lastname: Newman
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Ackroyd
authors.forename: Paul A
authors.initials: PA
authors.lastname: Dieppe
mesh_terms: D000368:Aged; D001168:Arthritis / Q000503:physiopathology / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome