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By Cheston Simmons, MD, Orthopedics
The Chester County Hospital
Published: March 30, 2009
The "Baby Boomer" generation is beginning to gray. Men and women in this group are demonstrating a high incidence of wear-and-tear arthritis - particularly in their hips and knees. The Boomer's focus on physical fitness and active recreation has led to increased stress on joints and an explosion of "overuse" injuries. Degenerative arthritis is showing up in patients in their 50s and 40s who were previously considered "too young" for joint replacement surgery. These younger patients are demanding solutions that allow them to continue activities like fitness, golf and tennis. Statistics show that the number of hip replacements in the United States is expected to double from 285,000 per year in 2005 to 572,000 per year in 2030. Knee replacement numbers are expected to skyrocket from 524,000 to over 3.5 million, an increase of almost 600%!
Thanks to advances in surgical techniques and prosthetic materials, patients no longer have to wait until they are in their 60s or 70s to get relief. In the past, many patients were told that knee and hip replacements may only last for 10 years. Wear or loosening of the metal and plastic parts would eventually cause failure - particularly in the young, active patient. Current studies demonstrate that more than 85% of replaced joints now will actually last up to 20 years. The latest prosthetic materials have up to 90% less wear in the laboratory. This dramatically improved durability allows joint replacement to potentially last for decades - making the procedure an option for the young and active.
One exciting new procedure is Hip Resurfacing, a novel alternative to total hip replacement that can allow the younger hip arthritic patient to resume more vigorous activity. Instead of removing and replacing the damaged hip ball, the surgeon preserves this important bone and covers the rough surface with a metal "cap" that articulates with a large-diameter metal socket. This combination has demonstrated excellent function and durability in early studies. Hip resurfacing may allow younger patients suffering from hip arthritis to resume fitness and athletic activities without pain.
Another exciting, less-invasive procedure is Partial Knee Resurfacing. Candidates who have arthritis localized to one portion of the knee no longer must have the entire joint replaced. This bone-and-cartilage-preserving technique leaves patients with two-thirds of their normal knee and can be done through a much smaller incision. The resulting knee typically feels much more natural than a full replacement. Rehabilitation and return to function are reduced by weeks compared to a traditional total knee.
We are placing greater demands on our bones and joints than our ancestors. Demand for joint replacement and reconstruction is growing rapidly. Arthritis patients are looking to their orthopedic surgeons for ways to maintain the active lifestyles to which they are accustomed. Fortunately, advances in surgical approaches, prosthetic design and rehabilitation are making joint replacement a viable option for millions of younger, active patients around the world.
This article was published as part of the Daily Local News Medical Column series which appears every Monday. It has been reprinted by permission of the Daily Local News.
Last Updated: 7/27/2009