There are 77 million Baby Boomers and people age 60 and older. Among other things, many will begin to feel the pain of joints that are wearing out and will need hip or knee replacement. About 544,000 hip replacements and 790,000 knee replacements are performed on Americans each year. Artificial hips and knees do wear out over time. In years past patients were often advised to wait as long as possible before having joint replacement surgery to avoid the possibility of needing a second hip or knee surgery at a time when they’re older, making recovery more difficult for them. According to Harvard Medical School:
- Among more than 60,000 people who had a hip replacement, only 4.4% required revision surgery in the first 10 years after surgery, but by the 20-year mark, 15% required revision.
- Among nearly 55,000 people who had a knee replacement, only 3.9% required revision surgery within 10 years of surgery; by 20 years, 10.3% required revision.
- Age did matter. Of those over 70 having hip or knee replacement, the lifetime risk of having a second operation on the replaced joint was about 5%. But this risk was much greater in younger individuals, especially for men. Up to 35% of men in their early 50s required a second operation.
Yet, medical experts say that younger people are increasingly getting joint replacements. The Wall Street Journal reports:
The population of patients under 65 getting joint replacements grew by about 200% over the past two decades.
For patients ages 45 to 64, there was a 211% increase in inpatient hip replacements and a 240% increase in inpatient knee replacements between 2000 and 2017…
Physically active people, those who run daily, or engage in high impact sports put more stress on their joints.
Certain intense, high-impact fitness activities can increase the chances of injury and arthritis—leading to more procedures.
Another reason for younger people needing knee or hip replacements is excess weight.
More than 40% of U.S. adults have obesity, the Centers for Disease Control and Prevention says, up from roughly 30% in 1999. Excess weight puts more pressure on the joints—roughly 4 pounds for each additional pound of body weight—leading more patients to need replacements earlier in life.
Medical researchers note that joint replacement is also up among those 65 to 84 but the rise is not nearly as pronounced as among younger patients. One physician interviewed by the WSJ claimed that half her patients are under age 65, up from 30% 10 years ago. The hurdles patients must go through to qualify for joint replacement at a younger age is not always easy.
Before surgeons can recommend the surgery—often a requirement of insurance coverage—patients need to show they attempted other possible solutions, such as physical therapy, weight loss and cortisone injections.
Medical technology involving joint replacement has improved over the past few decades. The improvements have mainly been in the therapy and procedures for recovery. Many of the appliance designs have not changed much in years. Some have been abject failures, due to metal-on-metal contact or poor designs (some of which continued to sell for years despite the defects). Whether joint replacement patients in their late 40s, 50s and early 60s ultimately need a second (or third) replacement in their lifetimes may not be known for years. Many are happy with their decisions and may be happy for life. Only time will tell.
Wall Street Journal: The People Getting New Knees and Hips in Their 40s
For an interesting history of hip implants see: I got my hip replaced at 39. Here’s why that might get more common
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