Easing the Pain of Rheumatoid Arthritis
Here's news exclusively for RA patients: Early intervention pays off in the long run -- and Dr. Andrew Weil offers up easy-to-do pain-reducing tips. go >
Yonkers, N.Y. - In Consumer Reports National Research Center's exclusive survey, 1,001 knee- and hip-replacement patients tell about the experiences they've had with joint replacement surgery. This unbiased survey, based on a nationally representative sample, found that although the surgery can have serious complications -- and does not always return patients to a state of perfect mobility -- it succeeds at the most basic level: pain relief. Even patients who were the most disabled going into surgery reported that on average, they had minimal pain in their new joints six months afterward.
Highlights of the Consumer Reports survey findings, published in the June issue, include:
Eighty-two percent of our respondents described themselves as "very" or "completely" satisfied with their new joint. But not all of our results were so encouraging: Recovery is long and sometimes painful. While most people stopped taking their pain medication after two months, 12 percent were still taking it after a year. Although 90 percent or more of patients could perform routine activities after a month, one-third of hip patients and one-quarter of knee patients said they still couldn't walk a half-mile one year after the surgery.
Five percent of respondents reported getting an infection shortly after the surgery, a significantly higher rate than reported in some major studies. Secondary complications were relatively common. These include a seriously weakened or contracted muscle. Thirteen percent of hip-replacement patients and 7 percent of knee- replacement patients said they ended up with legs of unequal length. Five percent of all patients required another operation to correct problems cause by the first one.
Some of the advice Consumer Reports offers people considering the surgery includes:
While conventional medical advice says to delay joint replacement as long as possible, Consumer Reports' survey suggests this strategy may have disadvantages. Consumer Reports found that respondents with the most severe and long-standing disabilities at the time of their surgery fared much worse than those who underwent surgery when they were less impaired. In general, Consumer Reports suggests discussing surgery with your doctor or seeing an orthopedic surgeon if the pain makes it difficult to sleep at night, medication doesn't alleviate the pain or has produced unacceptable side effects, you have trouble with the basics of living, or the pain rules out everyday activities.
Choose a surgeon who does no fewer than 50 per year of the procedure you're seeking. Look for someone who does only hips and knees and nothing else.
Take steps to prevent infection, including making sure you receive an intravenous dose of preventive antibiotics in the hour before surgery.
Of all the variables Consumer Reports asked about, complying with the exercises and activity prescribed by the physical therapist was one of the strongest predictors of how patients fared after the surgery. Respondents who said they followed the therapist's advice walked on their own considerably sooner, suffered fewer complications during recovery, and were significantly more satisfied with the surgery overall. Consumer Reports outlines low, moderate and high-impact joint-safe workouts for easing symptoms of arthritis in its report.
