Knee Replacement Is More Effective Than Nonsurgical Treatment for Relieving Pain in Knee Osteoarthritis

Although total knee replacement is common, its effectiveness compared with nonsurgical intervention has not been evaluated fully. In this trial, 100 patients in Denmark with moderate-to-severe knee osteoarthritis who were eligible for unilateral total knee replacement were randomized to surgery followed by 12 weeks of nonsurgical treatment or to nonsurgical treatment alone. Nonsurgical treatment consisted of supervised exercise, education, dietary weight-loss advice, use of insoles, and pain medications (e.g., acetaminophen, ibuprofen).

In intent-to-treat analyses, knee-replacement patients had significantly greater improvements in pain, function, and quality of life, but they also experienced significantly more serious adverse events (24 vs…