Panel: Total Knee Replacement is Safe and Effective

Total knee replacement is a safe and effective way of restoring mobility and alleviating discomfort for those suffering from persistent knee pain and disability, according to a panel of experts assembled by the National Institutes of Health who reviewed over 20 years of data on the procedure.

The 11-member panel included practitioners and researchers in orthopedics, rheumatology, internal medicine, nursing, physical therapy, rehabilitation, biostatistics, epidemiology and health services research as well as a total knee replacement patient.

The panel also found clear evidence of racial, ethnic and gender disparities in the provision of total knee replacements, noting that physician beliefs, limited familiarity with these procedures in minority communities and patient mistrust of the health care system may all play a role. The panel called for more research to determine the causes of these disparities.

"Total knee replacement is not for everyone," said panel chairman Dr. E. Anthony Rankin, an orthopedic surgeon from Washington D.C. "It's major elective surgery that carries a variety of important risks, but it often offers dramatic relief after other therapies fail."

For patients considering total knee replacement, the panel suggested they find out and consider the number of such procedures performed by their surgeon and hospital. "Basically, the more they do, the better they do it," Rankin said.

Panel members said proper alignment of the artificial parts to be implanted are critical to minimizing long-term wear and loosening. The panel said computer navigation may eventually reduce the risk of substantial misalignment, but noted that the technology is not yet proven and may be cost prohibitive for many hospitals.

Other sources: National Institutes of Health