Knee replacement surgery isn’t like peeling an apple; things young prospective patients should know

So I’m watching the evening network TV news the other night – I know, silly me – and I see this commercial pop up that visualizes artificial knee joint replacement surgery like peeling an apple.

Now part of the ad pitch is that this is for “partial knee replacement.”

You know what?  Partial or not, there’s no knee replacement surgery that is akin to peeling an apple, which I can do in my kitchen without anesthesia – if I do it correctly.

It’s a creative commercial, but too cute for comfort when dealing with an important surgical decision in one’s life. It drew me in the way it may have drawn in many other viewers.  I may choose to pursue knee replacement surgery someday (maybe some day soon if my once-torn ACL in one knee and torn meniscus in the other knee keep barking at me).  But I’m going to want more than marketing wizardry to convince me of any given device or any given approach.

The ads get cute with the young ages of the people depicted.  Yes, there are young people with knee arthritis and, of those, there is a smaller subset whose arthritis is so unbearable that they may consider knee surgery.  But do they make up the majority of candidates for the surgery – as these ads might suggest?

The trend of direct-to-consumer joint replacement marketing has become clearly well-established, and so has the trend of marketing these devices to younger and younger people.  They’re about to become patients.  Many of them are not patients yet.  They will be.

A brief review of the literature – and, granted, some of this is several years old (but also no older than some of the references the device company posts on its website) – produces clear caveats. This isn’t meant to be an exhaustive literature review; it simply is meant to remind consumers that ads depicting apple peeling and young patients don’t tell the whole story.  Prospective patients may not be told things like the following:

• A paper in an orthopedics journal commented with a note of caution: “The concept of minimally invasive joint replacement surgery is attractive to both patients and surgeons, but this study shows that it is technically demanding with a risk of complications.”
• Another journal article, “After Partial Knee Replacement, Patients Can Kneel, But They Need to Be Taught to Do So,” stated that this particular device being advertised “s appropriate for about 1 in 4 osteoarthritic knees requiring joint replacement.”
• A debate on one orthopedics website included this perspective: “although the short-term results look promising in a younger group of patients, consistent long-term data are lacking.”

See some of our past posts on issues related to this trend:

• Direct-to-consumer hip joint commercials

• Important shared decision-making questions on knee replacement surgery

• Medical devices and shared decision-making: Daisy chains of decades of device approval without rigorous assessment

• Is summertime bringing new wave of ads for artificial knees?

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