Walk This Way, Again

Advanced joint replacement procedures are attracting younger seniors with active lifestyles

For guitar legend Eddie Van Halen, it was the hip. For Aerosmith’s Joe Perry, it was the knee. If the spirit of rock n’ roll couldn’t make them feel 21 again, joint replacement was the next best thing. Many baby-boomers are following these rockers’ leads and undergoing joint replacement surgery to maintain their active lifestyle. Orthopedic surgeon Charles A. Hope II, MD, has also noticed that some of the people inquiring about joint replacement have younger faces than he once knew.

“Hip and knee replacement were pretty much reserved for end-stage arthritis in older individuals who were less active,” Hope says. “Now we’re seeing an increase in joint replacement volumes across the board."

Dr. Hope says that part of that increase can be attributed to the advances in the implant and in the technique of the procedure itself.

“The other part is that as more people stay active, and as more people become obese, the number of those at risk rises,” Hope says. “They end up wearing out their hips and knees sooner than they might have, but they don’t want to compromise or limit their activities.”

Though the number of patients asking for joint replacement has increased, Dr. Hope is grateful that the majority of his patients have what he calls “reasonable expectations.”

“We think activities like walking, cycling, swimming, or playing doubles tennis are reasonable,” Hope says. “We discourage impact-loading activities such as jumping or martial arts. A large percentage of patients find that they have good pain relief, good function, and good durability ten years after surgery.”

There is, however, a limit.

“The younger the patient is, the more seriously you have to consider the non-operative means, such as anti-inflammatory medication or activity modification,” Hope says. “Someone who is 40 or 45 and says they don’t like to take over-the-counter pain medication has unrealistic expectations.”

Dr. Hope adds that the younger a patient is, the less likely they are to see the implant last throughout the rest of their life. Furthermore, the longevity, function, and pain relief typically deteriorates with each additional surgery.

“The good news is that we have educational resources available to patients so that they can make an informed decision,” Hope says. “If non-operative means aren’t working, a patient may need to choose between using a wheelchair and narcotic pain medication or undergoing a surgery that will likely improve their function and quality of life. From my standpoint, the choice is obvious.” 
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