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Does Timing for Total Joint Surgery Matter?

TJA-importanceWhile choosing whether or not to get total joint arthroplasty (TJA) can be a difficult and daunting decision, new research shows that delaying it may have a negative impact on postoperative outcomes. Carlos J. Lavernia, MD, who helmed a study evaluating pre- and postoperative functioning, presented his findings at the American Association of Hip and Knee Surgeons’ (AAHKS) annual meeting.

Previously, Dr. Lavernia had studied TJA patients and found those with lower preoperative functioning had worse short-term self-reported outcomes after surgery than their higher preoperative functioning peers. Interested in examining the long-term impacts, Dr. Lavernia and his team looked at 105 patients from the original group and split them into those who were severely functionally impaired versus those who were functionally impaired. The demographics for both groups were very similar, though the first was 40% female and the latter was 73.8% female.

The patients had an average age of 65 years and 54 had total hip arthroplasties while 51 had total knee arthroplasties. The mean follow-up period for all patients was 11.2 years, 13 had revision surgery, and 43 passed away. However, there did not seem to be significant differences in revision or mortality statistics between the severely functionally impaired and functionally impaired groups.

The research team calculated scores using the Western Ontario and McMaster Osteoarthritis Index, Short Form 36, and the Quality of Well Being Scale both pre- and post-operation. They found that while all scores improved after surgery, those who had lower preoperative scores continued to have worse outcomes after the arthroplasty.

“We found that those who allowed their function to deteriorate significantly before undergoing TJA did not fully ‘catch up’ to patients who underwent surgery at an earlier disease stage,” Dr. Lavernia said.

This research emphasizes the importance of undergoing TJA earlier rather than later and treating the disease as early in its course as possible. Consulting an orthopedic surgeon can help you determine if surgery may be the appropriate intervention.

Concerned about joint pain? Wondering if orthopedic surgery is the right choice for you? Dr. Stickney is a Kirkland orthopedic surgeon who can help you return to an active, healthy lifestyle. Contact his office today at 425.823.4000 to learn about the surgical and nonsurgical options best for you. 


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