The recent news story about the Queen turning down the opportunity for knee replacement surgery in order to carry on with her forthcoming engagements gives us the ideal opportunity to discuss knee surgery in older patients.
While most people the Queen’s age don’t tend to put themselves through the 200-plus engagements she goes through every year, we’re long past the stage where the older generation are expected to spend the rest of their lives sat in bath chairs – and today’s generation of seniors are certainly more active (and want to be) than their grandparents were. And when knee problems set in, many people in later life want to take advantage of new surgical advances.
A potential placebo effect
But is it worth it? A study conducted earlier this year by the John Hopkins School of Medicine in Baltimore looked into post-operation reports from people over 65 who had undergone arthroscopic partial meniscectomy – a procedure which involves shaving or cutting out damaged or torn tissue, which accounts for an estimated two-thirds of knee operations on the over-65s in the US. And while the procedure is seen as a massively successful operation for younger patients who have suffered severe knee damage, the reports suggest it may not be the thing for seniors.
According to the study, which was published in February of this year, APM surgery only works on older patients as a placebo effect: the patient has had something done to their knee, therefore the knee must be better. In actual fact, studies prove that the procedure has little to no beneficial physical effect on patients over 65.
So, when is too old?
Then again, what the experts think about knee replacement surgery isn’t as important as what the patients feel after they’ve had it, and a few studies bear out the idea that it’s still worth it. A 2010 study found that patients aged 75 to 90 generally felt that knee surgery had improved the quality of their lives – out of the 48 people surveyed, all but one believed that having surgery was a wise decision.
A more recent study – conducted in 2014 – focused upon hip replacement surgery on people in their 90s and concluded that the results were comparable to a study group of younger patients – assuming that the older patient was generally in good health in the first place. However, and for obvious reasons, patients in their 90s stay in hospital for longer, and were more likely to be readmitted after three months – but infection rates were no different when compared to the younger study group.
So, in summary: it’s complicated, but not necessarily in a bad way. Some people of senior age will be happy to undergo London knee replacement surgery and feel better for doing so, while others will feel it’s not worth the bother and are willing to make accommodations to their lifestyle to work around their knee problems. Or, in the case of people like Her Maj, they’re just too busy to go through the downtime of surgery.