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Published on November 06, 2015

Knee replacement no longer a waiting game
Knee replacement no longer a waiting game

Knee replacement is one of those operations that many put off until the pain is intolerable or mobility becomes an issue.

But new research shows knee replacement surgery is happening at a faster rate, and that the choice is being made at a younger age.

More than 5.2 million patients had knee replacement surgery between 2000 and 2010, according to a study led by Sonja Williams, MPH of the national Centers for Disease Control and Prevention’s National Center for Health Statistics, published in the NCHS Data Brief.

Researchers found the rate of middle-aged and older adults getting knees replaced almost doubled over the years of the study.

And those choosing knee replacements are getting younger. While 98.1 percent of the adults were 45 and older, the average age dropped from 69 in 2000, to 66 in 2010. And more women than men are opting to have the surgery.

Robert Wilsterman, MD of Orthopedic Specialists in Falmouth has seen the same trend in his practice. “The younger age group is not willing to be disabled,” he said.

Many of the younger patients want knee replacements because they think they can resume the high energy activities they did before the surgery. That includes runners and those who participate in heavy impact activities.

But knee replacements are not made for that kind of activity, warns Dr. Wilsterman. Patients are instructed not to run, jump or do activities that require a lot of pounding on the knees after replacement surgery.

Those activities will have “deleterious” effects on the joint replacement, he said, and will cause it to wear out sooner.

Successful recovery also requires complete cooperation of the patient with physical therapy and ongoing exercises. “Getting better is a participatory sport,” Dr. Wilsterman said.

Similarly, hip replacements more than doubled, from 138,700 in 2000 to 310,800 in 2010. In that same period, the percentage of patients under 65 getting hip replacements grew to 46 percent, up from 36 percent, according to a study published in the NCHS Data Brief.

There are contrasts to the two surgeries but the “most dramatic difference is pain,” said Dr. Wilsterman. The hip replacement surgery is much less painful than knee replacement surgery. It can be a shorter recovery than knee replacement and it heals quicker.

Your knees and hips wear out for three main reasons: osteoarthritis, rheumatoid disease and post traumatic arthritis. Other reasons for hip replacement are fractures and osteonecrosis (decreased blood supply to the joint).

A fourth risk factor for knee replacement is obesity. Weight loss is often necessary prior to surgery. “If we could tackle obesity, we would have many fewer knee replacements,” said Dr. Wilsterman.

Many decide to have joint replacement after trying various over-the-counter pain medications, physical therapy and other lifestyle changes. There is no turning back from the surgery because you can’t undo it.

But joint replacements can change lives. Patients have little or no pain after recovery, they can return to their everyday routines and may even find new interests in lower-impact sports instead of running and jogging.

And today, new joints have longer warranties than new cars. Knee replacements last from 15 to 20 years and hip replacements around 30 years.

In the end, it’s a personal decision people should make after talking with their doctor.

Dr. Wilsterman recalled a 93-year-old patient whose bad knee had restricted her ability to walk with a group of friends. The only way she could continue was to have a knee replacement; afterwards, she spent the rest of her days doing the activity she loved.