Joint replacement surgery and transitional care
Hobbling around with a swollen knee or stiff hip may soon be passe for America’s seniors. Thanks to surgical advancements, people are seeking medical help sooner to alleviate chronic pain and receive artificial joints — some of them are in their 50s or are even younger.
Every year in the United States an estimated 1 million people undergo total joint replacement surgery to correct a damaged or arthritic joint. A joint forms the connection between two or more bones to add support and help you move. The knee, for example, is a hinge joint, and the hip and shoulder are ball-and-socket joints. The weight-bearing hip and knee joints see ongoing wear and tear and are replaced most frequently. The shoulder, ankle, wrist and elbow are other joints that are well-known to orthopedic surgeons.
Joint replacements are among the most common elective surgeries in the country. A study presented in March by the American Academy of Orthopaedic Surgeons (AAOS) found that people are seeking joint replacements earlier in life, in part because people are staying more active as they age and they want a better quality of life through retirement. The study also noted the rise in U.S. obesity, as obesity places greater stress on aging joints. People are also living longer, and the accumulative use of joints over the years leads to joint breakdown.
Dr. Ritesh Shah, an AAOS board-certified orthopedic surgeon with the Illinois Bone and Joint Institute of metropolitan Chicago, notes that on average people receive a total joint replacement between age 64 and age 66. Dr. Shah is seeing an upswing in total knee and hip joint replacements and says that total knee replacements are projected to increase as much as 400 percent in the U.S. by 2030 and that total hip replacements are projected to increase as much as 175 percent. “People are enjoying activities at an older age now and want to enjoy their quality of life,” Dr. Shah said. “The ability to ambulate
becomes very important to a good quality of life. Significant joint pain is a significant disruption of life and people don’t want to live that way anymore.”
Valerie Cadenhead, Owner of Right at Home of Central Arkansas is also seeing seniors be more proactive in improving their day-to-day mobility. “For older adults who do choose joint replacement, many are now bypassing rehabilitation centers and completing post-surgery care at home,” Cadenhead says. “With the right care supervision, it’s encouraging to see older adults back on their feet and enjoying activities again with their families and friends.”
When is joint replacement advised?
Prominent joints in the body can become severely damaged through the aging process, everyday wear and tear, and injuries. Or conditions like osteoarthritis, rheumatoid arthritis, bursitis, fractures, gout, tumors and other diseases can comprise the connections between bones.
Joint pain can be mildly irritating to chronically debilitating. One national survey found that roughly one-third of adults have experienced joint pain within the past 30 days. Women have higher rates of arthritis than men (26 percent vs. 19 percent) and more readily elect to have joint replacements, but nationwide, more men are joining the joint surgery ranks.
So when do you know if you need joint replacement surgery? Your doctor may recommend surgery if you experience chronic inflammation, limited movement, joint deformity, or when nonsurgical treatments such as physical therapy, medications and injections have not provided sufficient relief from continual pain.
Risks and benefits of joint replacement
During a replacement operation, damaged cartilage that cushions the joint surface is removed. Parts of the joint are also removed and fitted with a titanium, ceramic or plastic prosthesis to replicate normal joint movement. Total joint replacements do not last forever, and patients may eventually need a revision to their joint implants, but Dr. Shah notes that with today’s improved surgery methods and stronger, cement-less materials, replacement joints are now lasting up to 15 to 20 years on knees and up to 20 to 30 years on hips, depending on the activity level of the patient.