Deciding when enough is enough when it comes to the knee pain, stiffness and lack of mobility you’re experiencing can vary from patient to patient. As discussed in our previous post [internal link], timing is everything when it comes to knee replacements as leaving it too late can have a significant impact on your quality of life. Yet, many knee osteoarthritis sufferers, particularly those in their 50s and even 40s, may worry that their knee replacement may wear out too soon.

A recent wide-scale study, however, has found that majority of knee replacements last more than 25 years – much longer than was previously believed. Carried out by researchers from the University of Bristol and published in The Lancet last year, the study reviewed 25 years’ worth of operations, involving more than 500,000 patients.

Dr Jonathan Evans, lead study author and research fellow at Bristol Medical School, said: “At best, the NHS has only been able to say how long replacements are designed to last, rather than referring to actual evidence from multiple patients’ experiences of joint replacement surgery.

“Given the improvement in technology and techniques in the last 25 years, we expect that hip or knee replacements put in today may last even longer.”

How long will my knee replacement last?

The study looked at data relating to both hip and knee replacements, of which there are approximately 160,000 procedures performed each year in England and Wales. They found:

  • Total knee replacements: 93% lasted 15 years, 90% lasted 20 years, 82% lasted 25 years
  • Partial knee replacements: 77% lasted 15 years, 72% lasted 20 years, 70% lasted 25 years
  • Hip replacements: 89% lasted 15 years, 70% lasted 20 years, 58% lasted 25 years

The research was based on statistics gathered from the joint replacement registries in six countries which held at least 15 years of data; Australia, Finland, Denmark, New Zealand, Norway and Sweden. In the UK, our national joint registry data does not extend that far back, but the researchers noted that the results reflected the results from smaller scale studies of UK patients.

So, rather than waiting until pain, stiffness and lack of mobility becomes unbearable, these findings can give confidence to younger, more active patients that a knee replacement could be a viable option. During your consultation with Mr David Houlihan-Burne he will always discuss the benefits and risks of having surgery now or at a later date, as well as consider the non-operative treatments that could delay the need for surgery at this point.

At the moment we are all trying to get to grips with Boris’s latest rules on what you can or can’t do, so understanding the long-term, collateral damage of COVID is almost too much to take on board. However, we are already seeing a very real impact on waiting lists for elective surgeries on the NHS, particularly for joint replacements.

COVID has been described as a ‘wrecking ball’ through NHS waiting times and it seems that the consequences for those that were waiting for knee replacement procedure will be significant.

This delay is more concerning in light of a recent study that found that most patients wait too long to undergo knee replacement in terms of improvement to quality of life.

What happens if I delay my knee replacement?

Researchers at Northwestern University’s School of Medicine discovered that when people waited too long, they lost more function, resulting in weight gain, depression and other associated health issues. The outcome of the procedure that they eventually undergo may also be less successful.

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

“People are waiting and waiting to have the procedure and losing the most benefit,” said lead researcher Hassan Ghomrawi, associate professor of surgery at Northwestern University Feinberg School of Medicine.

“When people wait too long, two things happen,” Ghomrawi said. “The osteoarthritis causes deterioration of their function. Some of them wouldn’t be able to straighten out their legs, affecting their walking and mobility. When you can’t get exercise, you can start to develop other health problems such as cardiovascular problems. You may also become depressed. The overall impact can be huge.”

Yet, timing is everything, as knee replacements have a certain longevity. To discuss whether a knee replacement is the appropriate option for you at this moment, call us on 020 3693 2127 to arrange your consultation with Mr David Houlihan-Burne.

Mr David Houlihan-Burne writes an articles for the BUPA Cromwell Hospital magazine on the enigma of anterior knee pain:

“GPs and physiotherapists are often faced with patients of all ages complaining of pain at the front of the knee. This is an extremely common problem, accounting for 25-40% of all knee related issues seen in a sports knee clinic. It can be very debilitating and is traditionally poorly treated.”

Mr Houlihan-Burne talks to the Guardian Newspaper about new materials and technologies being utilised in knee reconstructive surgery:

“Mr David Houlihan-Burne, consultant orthopaedic surgeon at BMI Bishops Wood Hospital, says that, after many years of trial and error, new materials are becoming available to repair damaged knee cartilage and torn knee ligaments.”

Every year thousands of Britons tear a knee ligament, increasing their risk of developing arthritis. Carlo Barbieri, 51, a civil servant from Bexley Heath in Kent, was given a new artificial knee ligament.

Watford Observer quotes Mr Houlihan-Burne in 2009 regarding the design and opening of the Mount Vernon Treatment Centre

Consultant orthopaedic surgeon, David Houlihan-Burne, who has overseen the project, pointed to infection control being the most important aspect of the new building.

He said: “I suppose the most important thing for me was starting off here in a brand new building with a zero per cent infection rate. And that, from the public’s perspective is where we want to stay.

Article in Orthopaedics Today quoting Mr Houlihan-Burne as co-chairman at recent European Rapid Recovery meeting:

“The whole thing is underpinned by process optimisation. Do not start looking at surgical procedures without these processes in place or it will not work,” said David Houlihan-Burne, FRCS (Orth), specialist lower limb arthroplasty and soft tissue knee surgeon at The Hillingdon Mount Vernon NHS Hospitals Trust. Houlihan-Burne discussed the stages of process optimisation
and said various support services are available to those who want to implement fast-track arthroplasty.

Lionel Byrne, an 85 year-old grandfather is planning to keep active and independent well into his twilight years thanks to advanced and pioneering new surgery to replace his damaged right knee. The new treatment, Signature knee, uses MRI imaging to create a 3D image of the patient’s knee.

With this information the surgeon can carefully pre-plan the surgery and create a bespoke, patient matched knee replacement to replace their faulty joint. The patient matched instrumentation and ability to pre-plan the operation reduces the length of time spent in theatre to just 40 minutes compared with 60-90 minutes for a traditional procedure.

Lionel, a former advertising executive who had the new treatment back in March 2011, is now fully recovered and singing the praises of the designer knee, consultant and staff at BMI Bishops Wood Hospital who have helped him “keep active”.

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