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Baby boomers fueling boom in knee, hip surgeries
Question of the Day
_Bill McMullen, a former Marine and construction worker from suburban Philadelphia, had seven knee repair surgeries before finally getting a knee replacement at age 55 a decade ago. He took up weightlifting to spare his knees but damaged a shoulder and had it replaced two years ago. “People ask me if I’m happy and I say, `If you have pain, go and get it done,’” he said of joint replacement. “It was the best thing for me. I have no pain.”
People are urged to exercise because it’s so important for health, but there are “too many wannabes” who overdo it by trying to imitate elite athletes, said Dr. Norman Schachar, a surgeon and assistant dean at the University of Calgary in Alberta, Canada.
“They think if they’ve got a sore knee they’re entitled to having it replaced,” he said. “I think surgeons are overdoing it too, to try to meet that expectation.”
Dr. Ronald Hillock, an orthopedic surgeon in a large practice in Las Vegas that does about 4,000 joint replacements a year, sees the demand from patients.
“People come in and say `this is what I want, this is what I need,’” he said. “They could buy a cane or wear a brace,” but most want a surgical fix.
The numbers tell the story. There were 288,471 total hip replacements in 2009, nearly half of them in people under 65, according to the federal Agency for Healthcare Research and Quality, which tracks hospitalizations.
Knee replacements soared from 264,311 in 1997 to 621,029 in 2009, and more than tripled in the 45-to-64-year-old age group.
“Five or 10 years ago, a very small number of people under 65 were receiving this surgery. Now we see more and more younger people getting it,” said Elena Losina, co-director of the Orthopaedic and Arthritis Center for Outcomes Research at Brigham and Women’s Hospital in Boston.
She analyzed how much of this rise was due to population growth and obesity, and presented results at an orthopedic meeting in San Diego in February.
From 1997 to 2007, the population of 45- to 64-year-olds grew by 36 percent, but knee replacements in this group more than tripled. Obesity rates didn’t rise enough to explain the trend.
“At most, 23 percent of the 10-year growth in total knee replacement can be explained by increasing obesity and population size,” Losina said.
“This is a very successful operation. The only caveat is, all the successes have been seen in the older population,” who usually put less stress on their new joints than younger folks who want to return to sports. “It’s unclear whether the artificial joint is designed to withstand this higher activity,” she said.
If you have a good result from a joint replacement, don’t spoil it by overdoing the activity afterward, experts warn. Better yet, try to prevent the need for one.
“Being active is the closest thing to the fountain of youth,” but most people need to modify their exercise habits because they’re overdoing one sport, not stretching, or doing something else that puts their joints at risk, said DiNubile, the “boomeritis” doctor.
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