Total exchange of the joint

Today, baby boomers and seniors have a desire to stay active longer. As such, there has been a rise in total joint replacement procedures and along with it a more efficient, effective and safer surgery

By Yuliya Nemykina CTW Features

Crack open a tabloid magazine or tune into any “Real Housewives” show and it would be easy to think of the U.S. as the land of plastic surgery, but there is another type of surgery on the rise: total joint replacement.According to the Centers for Disease Control and Prevention, U.S. surgeons replaced 1,051,000 hips and knees in 2010 alone. Some argue the surgery’s popularity a mathematical illusion as baby boomers come into their 50s and 60s, creating the largest and longest-lived senior population in recent memory. “There isn’t really an increase in the percentage of patients in need of total joint replacement,” says Dr. Brian Parsley, president of the American Association of Hip and Knee Surgeons.

Others argue the demand in joint replacement has grown faster than the population, and the average age at the time of surgery has decreased.“Patients, especially younger patients, are unwilling to accept lifestyle accommodations and lead a more sedentary life when they know that, with surgery, they can lead a more active lifestyle,” Robb says.“Walking aids like canes and wheelchairs are not as accepted as they used to be.There have been changes in perception of physical disability and the way society judges people who use them.”

Generational characteristics also may play a role, says Dr. Steven Kurtz, the vice president and principal at Exponents, a biotechnological consulting firm. Kurtz wrote a seminal paper on the rise of total joint replacement, noting that baby boomers drive the joint replacements at a younger age, seeking to keep up their athletic lifestyles.“Sporty people get os- teoarthritis more often,” he says.“There is always some counter-example going, ‘I’m 50 years old, and I’m running a marathon,’ but there isn’t a big percentage of 50-year-olds running marathons.”

A 2012 Brigham and Women’s Hospital study published in The Journal of Joint and Bone Surgery supported the second hypothesis when it found the increase in arthoplasties between 1999 and 2008 had outpaced both the growth in the senior population and the rise in obesity.According to the American Academy of Orthopedic Surgeons, this surgery is the solution to joint pain that medications no longer control.According to William Robb, the orthopedic director for Illinois Bone and Joint Surgery, partial joint surgery may be possible, but not in cases of osteoarthritis or inflammation.

Kurtz also notes the procedure has become more efficient over time, allowing surgeons to replace more joints in a day, and the increasing number of people with fake joints might be good advertising for the procedure. “There are a number of people who have these devices implanted in them, and have had positive experiences,” he says.

Although some wear and tear on the joints is natural, there are a few things you can do to preserve your knees and hips for as long as possible.

Kurtz says high-impact activities like team sports and jogging tend to wear down the joints quicker because they’re more likely to injure the person compared to hiking or bicycling. Swimming and water sports may be especially effective, as it holds up your weight.“Your body is enclosed in water, and the force of it lightens the load on your joints,” he says.

It’s also important to keep up general health.According to Parsley, obesity puts a severe strain on your knees, which carry about five times the strain of your total weight. His study showed that obese patients need joint replacement seven to 16 years earlier than non-obese patients.

Diabetes and smoking also may cause issues by weakening the immune system, weakening the processes that allow your knees to rebound from injury and microscopic tears.

However, even artificial joints are not invulnerable to everyday wear and tear. Much like their bone-andcartilage counterparts, they may dislocate, loosen or become infected. In fact, according to the American Academy of Orthopedic Surgeons, prosthetics last about a decade, and you might have to replace one even sooner if you don’t take care of it. Parsley says patients have to especially watch out for immune system damage from smoking and diabetes, and be even more careful with the artificial joint than with a natural one.

“Your body has the ability to heal and recover when you have natural joints, but, when you have an artificial joint, you don’t have that healing ability,” Parsley says.“So, you have to do everything to keep it working for you.”

Luckily, joint surgery is improving. Robb says surgeons have streamlined and improved the procedure to reduce the risk or infection and chances of further pain.The new implants also last longer.“We’re stretching what would’ve been a 10-year span into 20 or more years,” he says.

According to Kurtz, today’s joints are created from metal, ceramics and plastic usually serve people quite well.“Artificial joints are very effective in returning people to their active lifestyles,” he says. © CTW FEATURES