NEW YORK (Reuters Health) - People with osteoarthritis might do well to undergo knee and hip replacement surgery before their pain becomes very severe and they have lost a great deal of joint function, the results of a study suggest.

Osteoarthritis is a degenerative joint disease that affects an estimated 21 million Americans, according to the report. The disease is marked by a progressive loss of cartilage and the development of bony overgrowths that can lead to inflammation and severe joint pain.

Typically, patients postpone having joint replacement surgery as long as possible. But delaying surgery can lower a patient's quality of life not only before the operation but for up to two years afterwards, conclude researchers.

The findings in the December 5th issue of Arthritis and Rheumatism indicate that joint replacement surgery should not be considered a "last-resort sort of procedure," Dr. Jeffrey Katz, the study's lead author, said in a prepared statement.

"We found that patients could have a positive impact on their quality of life by having this surgery before their arthritis became severe," said Katz, from Harvard University in Boston, Massachusetts.

Prostheses used in joint replacement surgery today can last up to 20 years, Katz and colleagues note.

In the study, 165 patients undergoing elective knee or hip replacement surgery were divided into two groups according to their level of pain and physical functioning.

Patients who experienced the most pain prior to surgery reported feeling the worst two years later, the researchers found. Additionally, five times as many patients who delayed their surgery required help with daily activities such as bathing or dressing.

"Although there are no validated indications for when a patient should optimally have total joint replacement, this data suggest that timing of surgery may be more important than previously realized," they conclude.

SOURCE: Arthritis and Rheumatism 2002.

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