Joint Replacements are Keeping Baby Boomers Active

Over the next 25 years, a dramatic increase in the number of joint replacements is anticipated, as the baby boom generation grows older. The American Academy of Orthopedic Surgeons predicts a 673 percent increase in first-time knee replacements by 2030. Fortunately, recent advances in joint replacement surgery have enabled many Americans to continue active lives.

Baby boomers are requiring surgery earlier and more often than previous generations because they lead more active lives and want to continue being active. New technology, better materials and improved surgical techniques have made this possible.

Arnold-Peter Weiss, MD is an orthopedic surgeon at Rhode Island Hospital who specializes in hand surgery. He was the first surgeon in New England to perform wrist replacement surgery and has the most extensive experience in the area.

Weiss says that he has started to see an increase the number of patients who come to him for wrist and finger replacements and expects the numbers to increase four to five times within the next five years.

X-ray of the implant in the wrist

In the past, the majority of joint replacement surgeries were performed to relieve pain from rheumatoid arthritis. Rheumatoid arthritis is genetic, painful and disabling. Now, more and more patients come to Weiss with osteoarthritis. This kind of arthritis may develop from an old injury, or may occur over time as the joint wears out. In the past, patients with osteoarthritis rarely sought wrist surgery because the only option was fusion of the bones to keep them from rubbing. Now, however, with new technology, the replacement parts can function nearly as well as the original cartilage and bone for both wrists and fingers, Weiss says. If a patient is unable to shake hands or complete daily tasks like buttoning a button, surgery makes these tasks possible.

Although many of his patients are motivated to seek replacement surgery because of the painful nature of arthritis, Weiss says they are also quite pleased with the cosmetic effects. This is especially true of patients with previously crippled hands and fingers.

Robert Shalvoy, MD is an orthopedic surgeon at The Miriam Hospital, specializing in knee reconstruction. Most of his patients have either pushed their knees to the limit through physical activity or through normal wear and tear. Shalvoy begins by meeting with patients to discuss the numerous options available.

The knee is a very vulnerable joint. It needs to be mobile and flexible as well as sturdy and strong. The cartilage that lines the surface of this joint is a “beautifully designed surface,” Shalvoy says, yet it does wear out over time. The cartilage you are born with is what you have; the body cannot re-grow it.

Patients who come to Shalvoy seeking relief from pain may ask about popular supplements such as glucosamine and chondroitin sulfates, which are supposed to help ease pain and inflammation that result from deterioration of the joints and arthritis. Shalvoy tells patients that while some research suggests that these supplements reduce inflammation, the research is far from exhaustive and the supplements can be quite expensive.

The next step up for patients with knee pain is a series of injectable treatments of hyaluronic acid. This substance is naturally found in the body; however, additional amounts can help to lubricate the knee joint and give it extra mileage. The treatments can reduce joint pain for a few months to a few years. This is also a very expensive treatment.

Another option for Shalvoy’s patients is physical therapy to correct a muscular imbalance or functional deficiencies in the knee. If none of these initial treatments are successful, or the cartilage has begun to erode, creating small holes, it may be time for a knee replacement or cartilage transplant surgery.

Knee replacement surgery is an “excellent and highly successful operation,” Shalvoy says. It allows patients pain relief and an improved quality of life, as long as patients do not attempt to continue their activities at the same level as before. If the replacement parts are not protected and respected, they are less likely to last—the new knee will break down and each time surgery needs to be performed, the more debilitating it may be.

Shalvoy also stresses that knee replacement should not be a final resort surgery; it is important, he says to have joint replacement surgery before a person is in considerable pain every day,  and before blood pressure skyrockets and weight is unmanageable.

A last option for patients who still want to remain very active is cartilage transplant, from a non-weight bearing part of the knee to a weight bearing part of the knee. Cartilage samples can also be extracted from the knee, grown in a lab and injected to cover the hole in the cartilage. Both these options are very new and best for a small injury or hole in the cartilage, not if the entire knee is worn.

The results for joint replacement surgeries are very good and continue to get better. Weiss considers a surgery successful when his patient is happy and can do what he or she would like without pain. In general, Weiss discourages his patients from high impact sports and activities, so that the joint replacement will not loosen over time. While Weiss encourages quieter sports, such as golf, he recognizes that his patients will “cheat” now and then.

Being active is the best way to prevent your original joints from wearing out. Physical activity helps to keep joints lubricated and limber, Weiss says, and while certain types of physical activities will be a factor in the need for replacement parts,  “you have to live life.” The good news is that replacement parts keep getting better, allowing aging baby boomers to stay active longer and more painlessly than ever before.

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