All posts related to "surgery"

Younger patients getting knees and hips replaced. Is this an additional burden on the healthcare system?

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

Study Review: the power of prehabilitation when undergoing joint replacement

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).

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Decreased rate of joint replacement for RA patients on biologics

Knee with osteoarthritis

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

ACR News – New frontiers in osteoarthritis treatment

What to doA clinical symposium yesterday at the ACR called New Frontiers in Osteoarthritis Treatment: The Role of Weight Loss, Surgery and Current Treatment Guidelines looked at the management of osteoarthritis (OA) patients through weight loss and exercise, surgery, and medications. The session also looked at the differences in treatment recommendations for OA.

Osteoarthritis and weight loss and exercise

In an interview with ACR Daily News, Stephen P. Messier, PhD, Professor of Health and Exercise Science at Wake Forest University, said: “When combined with exercise, weight loss is a level 1 method of treatment for knee osteoarthritis, and there’s strong support for both weight loss and exercise as the first-line treatment for knee osteoarthritis. I think the problem is that patients don’t know how to do it.”

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Knee replacement surgery rises for boomers

According to a government report in 2012, the rate of knee replacement surgeries has risen in the United States from 378,000 in 2003 to an estimated 704,000 in 2012 over the last decade. There is also a growing trend that people are doing these surgeries at a younger age.

The rise is in part due to the success rate of knee replacement surgeries. NBC Nightly News anchor Brian Williams talks about his injury and upcoming knee surgery. This news report is the first reportof a three-part series about knee replacement. We hope it will assist you in your decision on whether you want to proceed with a knee surgery. Remember to communicate with your healthcare team in your decision making process.

Below are some interesting stats on knee replacement surgeries.

Knee replacement infograph

Infograph courtesy of Healthline Networks and PearlDiver Technologies

Boomers Bust Out

The boomer generation isn’t just a huge group of people. It’s a huge group of people with attitude.”

There is a reason they’re called “boomers”. It’s because we are about to face an explosion of this population of older adults. And, they aren’t taking getting older lying down . . . They expect to live longer, have a better quality of life, and to have joints replaced sooner than their predecessors. This means there will be greater demands on the healthcare system. To read more about this phenomenon, read this CBC News article.

If this topic is interesting to you, you may also like an article, published in the Vancouver Sun last September, written by Dr. John Esdaile, scientific director at the Arthritis Research Centre of Canada (ARC), and Cheryl Koehn, president and founder of Arthritis Consumer Experts: “Baby boomers: The next arthritis generation