Joint replacement in younger patients continues to increase. More joint replacements are being done now than ever. In fact, it is estimated that there were more than 1 million hip and knee replacements done in the U.S last year. This is more than double the number done just 10 years ago.
Although it is of no surprise that the more senior age group, the Medicare age patient, makes up a significant portion of this population – it may come as a surprise to many that half of all of the joint replacements done in this country are in the under 65 age group. The mid 50’s is the time when the arthritic joint starts to become painful and, for many, incapacitating. It is projected that the volume of hip and knee replacements will more than double by 2020, with joint replacement in younger patients growing exponentially.
Several things have changed over the past 10-15 years or so that affect this demographic. The technology for hip and knee surgery is much better and the implants are lasting much longer than we thought they might. As a result, surgeons are less reluctant to recommend joint replacement in younger patients who are severely limited by arthritic pain than they were even a decade ago.
In addition, the younger patients are demanding this surgery in greater numbers, unwilling to just “live with the pain,” which is what they were often told in the past. This “Boomer” generation is not content with just dialing back their activity and greeting old age without a fight! They want to stay extremely active and out of pain—so they opt for a new joint.
Another one of the real drivers of the joint replacement demand is the rapid rise in obesity in this country. Being overweight greatly increases the stress on your hips and knees and if you are overweight in your younger years—your joints have had to put up with added stress for a long time. This long term stress on the weight bearing joints has led to the more rapid deterioration of hip and knee joints in this younger population than was seen in the previous generations.
There is no doubt that a younger patient who has been in severe pain for a long time is clearly happier once they have their degenerated joint replaced. Again, the goal of joint replacement surgery is to dramatically reduce pain and improve overall function of the impaired joint. One concern, which is shared by most surgeons, is how long will this replacement last? Like most mechanical things, there is a failure rate inherent to replacement parts. We expect most current technology joint replacements to last over 20 years—in 90% of patients under ordinary use patterns.
Most surgeons worry that patients who go back to high intensity sports such as long distance running, contact sports or heavy weight lifting—may wear out their new parts more quickly than patients who do not participate in such activity. Consequently, most surgeons will advise patients against these sports.
Joint replacement in younger patients is a real solution to their severe hip or knee pain from arthritis. Until a biologic cure or prevention is found for severe arthritis of our joints, we have no real way to slow down the progression of the deterioration from this disease. In the early stages—anti-inflammatory meds, cortisone injections, exercise and weight loss are the mainstays of treatment. These treatments will help for a time and a rational patient will try these treatments for as long as possible. Eventually, these treatments will fail to work. If a patient is young at the onset of pain symptoms, they will still be young when these treatments stop working. At that point, a skilled and experienced joint replacement surgeon can provide a level of pain relief with a replacement joint that will allow patient to return to a pain free, productive lifestyle that they have not experienced in many years!