Having a condition like knee arthritis is debilitating and it can have a significant impact on your quality of life.
Think about how often you use your knees in your everyday life – for walking, sitting, going up and down stairs, getting in and out of a car… Arthritis causes chronic pain which gets worse as the condition develops. It can affect your ability to work, socialise and do the things you used to enjoy. In fact, it’s hard to think of any aspect of your life that isn’t impacted by knee pain, even sleep which can become disrupted by arthritic pain.
A study by Versus Arthritis found that people with arthritis are 20% less likely to be in work than someone without the condition. In 2021, 23.3 million working days were lost due to musculoskeletal conditions.
What is knee replacement surgery?
If you have severe arthritis you will normally be offered knee replacement surgery, which entails removing your damaged knee joint and replacing it with a prosthetic implant. There are two types of knee replacements – total and partial. A total knee replacement involves removing the natural joint in its entirety and replacing it with an artificial joint. In a partial knee replacement, some of your natural joint is retained and only part of the joint (the diseased part) is replaced. There are pros and cons to each and your orthopaedic surgeon will discuss your particular case with you as not everyone is suitable for a partial knee replacement.
You may also hear the terms ‘primary knee replacement’ and ‘revision knee replacement’. A primary knee replacement is where your natural knee joint is replaced with a prosthetic implant while a revision knee replacement involves removing a prosthetic implant that has failed and putting a new one in its place. Most artificial knees last around 15 years although occasionally a patient may develop an infection in the implant shortly after surgery and it may need to be removed.
In many cases, patients are now suitable for Mako robotic assisted knee replacement surgery, which generally enhances the accuracy of the surgery and can result in a more comfortable implant and faster recovery.
Study into quality of life after knee replacement
As orthopaedic surgeons we advise patients that knee replacement surgery is the most effective way to regain mobility, reduce pain and restore quality of life if you have knee osteoarthritis. A number of independent studies confirm this, including one of the most recent that was published in The Bone and Joint Journal in 2023.
Methodology
A team from The Royal Infirmary in Edinburgh set out to discover whether a primary knee replacement restores health-related quality of life to levels expected in the general population. They looked at data from two sources – patients who’d had a primary knee replacement at a university teaching hospital between 2013 and 2019 and the Health Survey for England between 2010 and 2012.
Patient-level data from the HSE was used to represent the general population, while propensity score matching was used to balance covariates and facilitate group comparisons. Health-related quality of life was measured using the EuroQol five-dimension questionnaire which asks patients to consider:
- Mobility
- Self-care
- Usual activities
- Pain and discomfort
- Anxiety and depression
They rate each area according the following levels of possible impairment:
- None
- Some
- Extreme
Researchers then summarised this information using the Index and EuroQol visual analogue scale.
What the study showed
Compared to the general population, patients awaiting knee replacement surgery had significantly lower scores when measured against the EuroQol five-dimension questionnaire – an average of 0.620 compared to a general population average of 0.796. However, one year after surgery, the average score of patients who’d undergone knee replacement surgery had improved significantly (an average change of 0.32), bringing these patients onto a par with the general population. In fact, compared to the general population the EuroQol visual analogue scale scores were significantly higher in those who had undergone surgery.
The research team concluded that the study clearly demonstrated that patients with knee osteoarthritis have a poorer quality of life than the general population. However, within one year of undergoing knee replacement surgery, their quality of life has risen to the levels expected for their age, sex and body mass index.
A cause for optimism
If you are experiencing worsening pain and loss of mobility due to knee arthritis, studies like this are a cause for optimism as they show that joint replacement surgery can significantly improve your quality of life. It is normal for patients to feel apprehensive at the prospect of a major surgical procedure but knee replacements are now routine and your orthopaedic surgeon and their team will work with you to reduce the risk of complications and ensure you have the best possible outcome.
In May 2023, a patient of Joseph Queally who was seen at Beacon Hospital rated his care at five stars on the Iwantgreatcare website.
He wrote that Mr Queally “went to great lengths to sort out my knee”.
For more information about diagnosing and treating knee arthritis, contact us.
