• Top 10 Reasons Not to Get Joint Replacement Surgery

    by Dr. Clark H. Hansen
    on Oct 21st, 2016

If joint replacement surgery is an option you are considering, please take the time to watch this video and read the following report.

 

Knee and hip replacement surgeries come with many risks and complications. Several years ago we queried the National Sampling System for Medicare and found that in the year 2008 alone, there were 17,500 serious complications related to knee replacement surgery resulting in 5,000 patient deaths.

These facts come from the Regenexx website. Our goal is to provide information that will help you make the right choice for you.

1. Heart Attack Risk Dramatically Increases Following Knee or Hip Replacement

There is an increased incidence of heart attacks seen with knee and hip replacement surgeries. This study shows that among patients 60 and up, those with a hip replacement were 25.5 times more likely to experience a heart attack in the two weeks following surgery. Those with knee replacements were 31 times more likely to have a heart attack.

Why do these heart attacks happen? In our office we call these surgeries “amputation with insertion of prosthesis.” When you completely excise a joint, there is severe trauma to the blood vessels and bone marrow space. This trauma likely leads to a higher risk of blood clots that can travel to the heart and obstruct the arteries. In addition, for some patients the stress of undergoing the joint amputation may be enough to induce a heart attack.

Conclusion: Avoiding a knee or hip replacement lessens your risk of a heart attack.

2. Bleeding Stomach Ulcers Significantly Increase Following Knee or Hip Replacement

One study shows that bleeding stomach ulcers are a significant problem following knee
or hip replacement. A Danish knee and hip replacement surgery registry was reviewed, and then matched subjects without surgery were used as controls. There was a staggering sixfold increase in stomach bleeding following a hip replacement and a two- to three-times increase following a knee replacement. The elevated risk lasted 12 weeks in hip patients and 6 weeks in knee patients. Using an acid-reducing drug did decrease the risk for hip patients but not for knee patients.

Conclusion: To eliminate your risk of bleeding stomach ulcers due to knee or hip replacement, consider other treatment options besides surgery.

 

3. Metal Ions in the Blood Caused by Knee or Hip Replacement

Our website shares known knee replacement complications surrounding wear particles. Wear particles are microscopic pieces of metal, ceramic, or plastic that break off of the knee or hip prosthesis and irritate the local tissues and/or enter the bloodstream. These issues are more significant now that new partial or resurfacing knee and hip replacements are becoming popular, as these new devices need to be metal to withstand the additional stresses placed on smaller parts.

The research concerning what happens to your body when it’s implanted with metal seems to point in the same direction: patients who receive knee replacements have higher levels of various metals in their bloodstream. For example, researchers from Austria demonstrated that the size of the prosthesis was directly correlated with the blood concentration of metal ions (the larger the knee replacement device, the more metal ions that were found in the bloodstream). One group in Italy found more of these metal ions in knee replacement patients who had a loose prosthesis. Why? In some patients the knee replacement device may not be seated tightly or may not have bound to the surrounding bone. This would cause more wear between the bone and the metal prosthesis thus leading to more metal particles. A group in Germany found that metal ions in the blood increased precipitously after a knee prosthesis was implanted. A different German group also found higher serum levels of chromium and cobalt in knee replacement patients than patients without knee replacements.

Conclusion: While we don’t know the long-term implications of these higher serum metal concentrations in knee and hip replacement patients, obviously, high levels of metal in the blood is not a good thing. And the alternatives being used to attempt to eliminate the wear creating these hazardous metal ions are creating their own toxic mix of wear particles. The bottom line is there is no safe hip replacement option right now, which should concern anyone considering having this invasive surgery.

4. Patients with Mild Pain Should Seek Knee Replacement Alternatives

You might think we must know that the knee replacements performed every day work very well; after all we perform 600,000 of these procedures annually, they’re FDA approved, and knee replacement devices are paid for by every insurance company. While there is some data from various studies, a large study that looked at long-term data was very disappointing. In fact, it argues that we should be looking at knee replacement alternatives.

A Lancet article raised some concerns about the wide range of patients who were receiving total knee replacements. Their concern was that there were not only patients who were disabled by knee pain but also patients with only mild symptoms. Our website discusses the issue of joint replacement device manufacturers aiming their advertisements at a younger and more active population with knee pain. You can’t watch TV without seeing commercials with young and active people advertising the latest knee and hip replacement device. In fact, with knee and hip arthritis rates soaring in younger people, the manufacturers of these devices have found a new and bigger market than in the elderly.

The study author noted that the growing number of younger people undergoing knee replacement surgery is something of a mystery. In fact, they noted that an international panel found that surgeons’ recommendations for knee replacement were not correlated with pain, disability, or radiographic severity. The study author commented that only patients with long-standing pain at night or pain with weight bearing (just walking) should undergo the invasive surgery. Finally, the authors noted that knee replacement alternatives that are nonsurgical should receive major research attention.

Conclusion: If you are a younger patient experiencing only mild knee pain, seek nonsurgical alternatives to relieve your symptoms, such as the Regenexx-SD procedure. At three months following the Regenexx procedure, greater than 50% of knee patients who responded reported greater than 50% relief, and the percentage of patients reporting greater than 50% relief increases over time, up to 90% of patients at 48 months following the Regenexx-SD procedure. 

5. Severe Persistent Pain Despite Total Knee or Hip Replacement

Most patients believe that the vast majority of their pain will go away after a knee replacement. So what’s the reality? There are a number of new research studies that show that only a minority of patients after a knee replacement are pain free.

Knee arthritis is a problem whereby the cartilage inside the joint gets worn out and degraded. The bone then reacts (or as a new study shows the bone actually reacts first in arthritis) and begins to deform with bone spurs. In some patients the knee becomes very painful, however in others it doesn’t. This is the conundrum of knee arthritis—you generally can’t tell who hurts by looking at the severity of their x-ray or MRI.

Knee replacement is one option to treat arthritis. However, despite massive increased risks for heart attack and stroke, many patients surprisingly have pain after a knee replacement. For example, the most common pain score after knee replacement in one study was a staggering 5 out of 10! Why would you take this huge risk if you’re not virtually guaranteed that your knee will be without pain?

There is an interesting study on the percentage of patients who continue to experience severe persistent pain despite having their knees replaced. What was really surprising was that 44 percent of total knee replacement and 27 percent of total hip replacement patients continued to experience postsurgical pain of any severity three to four years after surgery. More surprising was that 15 percent of total knee replacement patients reported severe to extreme persistent pain despite invasive knee surgery. The persistent pain was most commonly described as aching, tender, and tiring. In addition, major depression was more common for patients experiencing pain after knee replacement. This is likely a confounder, as who wouldn’t be depressed if there was still severe knee pain after going through an invasive surgery to get rid of knee pain?

Severe pain despite joint replacement is more common than we would have guessed, and based on our experience, it is often caused by an inaccurate diagnosis of the pain generator before surgery.

Conclusion: Most patients who opt for a knee replacement would peg the likelihood that they would be pain free after the surgery at 90% or more. However, this isn’t reality. If you’re considering a knee or hip replacement, it likely makes sense to insist that someone take the simple step of numbing the joint under imaging guidance to ensure that the joint is really the culprit. If this doesn’t take away over 75% of the pain, this isn’t the surgery for you. In that case keep searching for a cause (which in our experience is often nerve issues in the low back). 

6. Knee Replacement Prices Soar as Outcomes Drop and Complications Mount

How much does a knee replacement cost? This article does a great job of putting the outrageous costs of knee or hip replacement in perspective. With the average cost of $50,105 (in 2014) for a hip or knee replacement in the United States, this exceeds the average annual income in many states. Cost many be one reason to look for a knee replacement alternative.

The writer of the article compared that whopper $50,105 cost to the average income in all 50 states. She also adjusted that mean cost of the surgery by state. Eighteen US states had knee or hip replacement costs that exceeded their average annual income. Perhaps more disturbing is that 7 in 10 Americans don’t have enough saved to cover the cost in retirement. Even if the surgery is covered by a solvent Medicare program, the 20% out-of-pocket costs would completely or substantially drain the life savings of 60% of Americans. Is it time for a less invasive knee replacement alternative?

The states in which the cost of the procedure exceeds income are listed below. Is yours on the list?

Alabama Indiana Arizona Louisiana California Mississippi Colorado Missouri Florida Nevada Georgia New Jersey New Mexico Oklahoma Pennsylvania South Carolina Tennessee Texas

As we’ve discussed, these surgeries are associated with wear particles that can spike metal levels in the blood, huge increases in heart attack and stroke risk, and wearing out at fast rates in active people, and the outcomes aren’t as good as usually advertised.

US healthcare is very expensive. As a country we have missed a huge opportunity to fix our cost problem by not turning the healthcare market into a consumer-driven model.

Conclusion: Why pay huge amounts in copays, deductibles, or cash for invasive and risky surgeries that have huge side effects and so-so outcomes? Instead, consider treating your arthritis through a simple stem cell injection.

Conclusion

Complications due to knee and hip replacement are numerous, as these are big surgeries. Some of the possible complications you must consider include increased risk of heart attacks, local irritation of the tissues and higher concentrations of toxic metal ions in the blood due to metal-on-metal hip resurfacing implants, and severe knee pain despite knee replacement. We also know age impacts knee and hip replacement complications, and the odds of perishing from a hip replacement are 13 times higher for patients age 80 and over. In addition, heavier patients also do poorly after hip or knee replacement when compared to their lighter counterparts.

With so many possibilities for complications due to joint replacement, consider the safer alternative—Platelet Rich Plasma (PRP)  injections. Review how PRP compares to knee and hip replacements.

As a knee surgery or knee replacement alternative, the Regenexx-SD procedure may help alleviate knee pain and the conditions that cause it with a simple office injection procedure. Patients are encouraged to walk the same day, and most experience little to no downtime from the procedure.

 

Author Dr. Clark H. Hansen Dr. Clark H. Hansen is a licensed Naturopathic Medical Doctor (N.M.D.) who has been in private practice in Scottsdale, Arizona, since 1986. He is the President and Medical Director of the Hansen Clinic of Natural Medicine, Aesthetics and Mesotherapy. Dr. Hansen is one of the most well respected Naturopathic Physicians in the country and a Diplomat of the World Society of Anti-Aging Medicine.

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