New research shows that patients undergoing total joint replacement are younger now than they were in 2000. According to a review from the National Inpatient Sample (NIS) database, the average patient undergoing a total hip replacement (THR) in 2014 was 64.9 years, while the average patient in 2000 was 66.3 years. In parallel, the average patient undergoing a total knee replacement (TKR) was 65.9 in 2014, and 68.0 in 2000.
Dr. Matthew Sloan, lead researcher and orthopaedic resident at the University of Pennsylvania in Philadelphia, tells Reuters Health by email: “These differences may not seem like much, but an average decrease of two years in a pool of 1 million people is a significant difference. It’s also a meaningful difference when you take into account the fact that these total joint replacements have a finite lifespan.”
Dr. Sloan further explains: “The technology for total hip and knee replacements continues to improve. However, at some point, the implant wears out. We believe modern implants without any unforeseen complications should last 20 years or more. The problem with an increasingly younger group of patients having these procedures, it becomes more likely that the implant will wear out during their lifetime. When this happens, a second surgery is required to revise the joint replacement. These procedures are not as successful as the initial surgeries, they are bigger operations, they take longer, and now the patient is 20 years older and not as strong as they were when they had the initial procedure.”
Because a second surgery is riskier and prone to complications like early failure or infection, the goal is to wait as long as possible so that a patient will undergo one surgery in their life. Other findings presented at the American Society of Orthopaedic Surgeon’s annual meeting include: Continue reading
Total hip arthroplasty (THA) and total knee arthroplasty (TKA), also known as hip/ knee replacements, are surgical procedures in which parts of the joint are replaced with artificial material to restore function and ultimately reduce pain. As an arthritis patient, if other forms of treatment have not improved the joint’s ability to function or been able to prevent additional damage, your rheumatologist may recommend arthroplasty.
A recent study conducted by a team of Canadian Physiotherapists at The University of Western Ontario has discovered valuable information regarding the impact of prehabilitative care prior to arthroplasty. The team wanted to see if education and exercises for patients before surgery (prehabilitation) impacts pain, function, strength, anxiety and length of hospital stay after surgery (post-operative outcomes).
Image courtesy of yodiyim at FreeDigitalPhotos.net
A study published in the European League Against Rheumatism Annual Congress last month shows that the incidence of knee and hip replacement declined after the introduction of biologics to national rheumatoid arthritis (RA) treatment guidelines.
The study looked at 30,868 patients diagnosed with RA at the rheumatology department between 1996 and 2011 and compared them with 301,527 controls from the general population. The baseline total knee replacement (TKR) incidence rate per 1,000 person-years was 5.87 for RA versus 0.42 for the controlled group. Prior to 2002, the incidence of total knee replacement increased among RA patients, but started to decrease after the introduction of bDMARDs and their associated guidelines in 2003. In February of 2007, the rate of TKR changed to 1.8 TKRs/1,000 person. Over the study period, the incidence of total knee replacement and total hip replacement increased among the general population controlled group. In contrast, there was a downward trend among RA patients.
Lene Dreyer, MD, from the Center for Rheumatology and Spine Diseases in Denmark, is one of the author the study. Dreyer explained: “Our findings show a clear downward trend in these two operations in RA patients in Denmark since the additions of [biologic disease-modifying anti rheumatic drugs] bDMARDs to treatment protocols. Also, the overall pattern of our findings is in line with those recently reported from England and Wales.”
Below is a video examining the quality of rehabilitation care, specifically in hip and knee replacements: Continue reading
A recent study published in the May 21 issue of the Journal of the American Medical Association states that physical therapy does not help pain or function for adults living with hip osteoarthritis. Continue reading
British surgeons implanted a first-of-its-kind hip joint made on a 3D printer on 71-year-old Meryl Richards. The implant is held together with the patient’s own stem cells. After the surgery, Richards was able to walk unassisted.
The implant is made from titanium metal and was tailor-made for Richards using precise measurements taken from detailed body scans. Before this operation, Richards had six other hip replacements that left her pelvis very weak – to the point where her leg had punched a hole through the bone. As a result, one leg was two inches shorter, causing immense pain and making her disabled and wheelchair bound.
Would you implant a 3D printed joint or bone? What are some concerns you may have? Continue reading