June 29, 1999 Referring physicians are too pessimistic about the risks of knee replacement surgery, according to a University of Toronto study in the June issue of the Journal of Bone and Joint Surgery.
The study examined all 18,530 knee replacements performed in Ontario over a seven-year period and found the chance of needing a second operation following primary surgery was only between four and eight per cent - about half the rate expected by family doctors and rheumatologists.
"Referring physicians need to be better informed of the low risks associated with this procedure," says lead author Peter Coyte, a health economist at U of T. While the overall risks of re-operation were low, the study reports a slightly higher risk of follow-up surgery for younger patients with more active lifestyles and for patients living in urban centres. Coyte suggests this may be due to the greater concentration of specialists in urban centres who see patients with already more advanced stages of osteoarthritis.
Knee replacement surgery has been growing at an annual rate of 15 per cent since 1981 and is most common in patients over 60 years old. The study, the most comprehensive assessment of knee replacement recipients to date, was funded by the US Agency for Health Care Policy and Research.
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