Ladies - don't wait for your knees to wear out!

21/02/2008

Women wait longer to pursue knee-replacement surgery than men do, but by postponing surgery until they can no longer stand the pain, they risk putting their mobility and quality of life on hold indefinitely - according to Lynn Snyder-Mackler, a certified sports physical therapist and athletic trainer.

Her research of 229 male and female candidates for knee surgery revealed that doctors tend to advise their patients to wait to have knee replacements until they just can't stand the pain any longer - but with disastrous results for women. Said Snyder-Mackler  “Our research shows that's bad advice - and worse for women than it is for men - because your level of function going into surgery generally dictates your level of function after surgery."

While the men generally were stronger and had more knee function than the women, the test results showed a much greater degree of physical disability in the female knee-replacement candidates compared to the males in the group.

“The women afflicted with osteoarthritis were at a much more advanced stage than the men with the disease,” she said. “The women all had painful end-stage osteoarthritis, where the cushion of cartilage padding the knee bones has completely deteriorated and you basically have bone hitting against bone.”

So why are women waiting so long before pursuing surgery? Snyder-Mackler believes there may be a number of reasons: possibly women can bear pain better than men, or a woman's world increasingly revolves around the home as we age, or it could be that women are just trying to follow doctor's orders.

“Osteoarthritis of the knee is one of the most common cause of disability. It's a disease of age that affects more women than men on a 60-40 basis,” added Snyder-Mackler. “Physicians generally have advised patients to wait as long as they can before pursuing knee replacements, with the thinking that it is a once-in-a-lifetime surgery that should last an average of 20 years. But when you feel profound buckling and weakness in your knee when climbing stairs, that is a major problem. You compensate - eventually, you may come downstairs only once a day.

“As a result, you become sedentary and that's not good for your health. Earlier intervention can help preserve your mobility and quality of life.”

In a related study, Snyder-Mackler worked to determine the effectiveness of “unloader” knee braces in reducing pain and improving function in osteoarthritis patients. The research showed that these braces actually promote pain relief by diminishing muscle contractions rather than by “unloading” or separating the joints. Such knee braces may provide an inexpensive treatment option for some osteoarthritis patients.