Living with knee pain? A new study has found that 90% of Americans with osteoarthritis suffer too long before having a knee replacement that could improve their quality of life.

“When people wait too long, they lose more and more function and can’t exercise or be active, thus leaving them open to weight gain, depression and other health problems,” said lead investigator Hassan Ghomrawi, associate professor of surgery at Northwestern University’s Feinberg School of Medicine.

In addition, the surgery may not be as successful, Ghomrawi said.

“There are multiple studies that have shown that patients who do surgery when their function is very deteriorated may improve quite a bit, but their improvement is still not to the average,” Ghomrawi said. “They lag behind in optimal benefit.”

On the flip side, the study also found that 25% of people who do choose knee surgery are getting it too early, running significant risks, including potential complications, while incurring the cost of major surgery potentially without getting much extra benefit in mobility.

“There are a million knee surgery procedures occurring in the United States each year,” Ghomrawi said, “and 25% of those are premature. That’s a lot of patients.

Because artificial knees wear out after 20 years or so, early adopters are also setting themselves up for yet another knee replacement later in life, Ghomrawi said, which is typically a much more difficult surgery with a poorer outcome than the original.

An objective algorithm

The study, published Monday in the Journal of Bone and Joint Surgery, followed over 8,000 people with symptoms of knee osteoarthritis for up to eight years.

While other studies have looked at people who underwent the knife, this study is believed to be the first to examine the timeliness of knee replacement among people who might benefit from the procedure, Ghomrawi said.

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