Tuesday, July 11, 2017

Understanding and Preventing Knee Replacement Surgeries

Increased Knee Replacement Surgeries Among Baby Boomers

More - and younger - Americans are getting knee replacements today than ever before. It’s an alarming trend, so it’s important to learn why this is happening and how you can prevent knee problems that require surgery.

According to the Arthritis Foundation, knee replacement surgeries have increased by 188 percent over the last 10 years in Americans aged 45–64. These surgeries are not easy procedures, either. They require weeks of recovery time, and some patients report having residual pain for as long as a year after the surgery.

So, what’s causing the rise in knee replacement surgeries and what can you do to avoid needing it?

Why the Increase in Knee Replacements?

Overall, the Arthritis Foundation found that the number of knee replacement surgeries rose about 120 percent over the last decade for adults between 45 and 84 years of age, with the largest uptick among baby boomers. Many myths try to explain that increase. For example, some people assume that activities such as running and high-impact exercise wear out the joints, causing pain. However, researchers have conducted many studies on the long-term effects of running, and all have shown that it does not damage the joints. In fact, some studies show that running strengthens knees and prevents future pain from worn joints because it increases the cartilage layer that protects the knee.

Three factors seem to drive the increase in knee replacements in baby boomers. The Centers for Disease Control (CDC) estimates that the top cause for the increase is obesity. Americans are heavier now than they ever have been, and the extra weight can prematurely wear the joints, damage ligaments and reduce mobility, which can contribute to bad knees.

The second reason for the increased number of knee replacement surgeries is that baby boomers are more active than previous generations, and they’re not willing to wait for knee pain to become debilitating before opting to have surgery. The Orthopedic Institute of Pennsylvania (OIP) points to arthritis or genetics – which is often a determining factor in osteoarthritis – as the third cause of knee replacement surgeries. Osteoarthritis cannot be prevented, and can cause debilitating pain.

Preventing and Prolonging Knee Replacement

While knee replacement surgery might seem like an easy fix to a painful problem, it’s actually more involved and painful than most older adults realize. Unlike hip replacement surgery, patients report prolonged swelling, bruising and pain during recovery and longer recovery times. Orthopedic physicians recommend waiting as long as possible to have the surgery because, as with any surgery, there can be complications. Also, the average life of a replacement is about 20 years. Because baby boomers are opting for surgery sooner, they will likely face a second surgery during their lifetime.

The Truth About Knee Surgery

Sometimes, there’s just nothing that can prevent knee replacement surgery. Margie Dutcher, a retired clinical advocacy nurse from St. Petersburg, Florida, is currently recovering from such a surgery.

“I have an entirely new joint – my right knee was completely replaced,” she says. “Nothing that I did caused this or could have changed all this, unfortunately.”

Her diagnosis prior to surgery was tricompartmental arthritis, complicated by a torn meniscus and bone spurs.

“Rehab starts the same day as surgery,” explains Margie. “I got to my room from recovery about 4:30 p.m. and the physical therapist was there waiting for me. With his assistance and the walker, we walked to the door. I had therapy twice a day in hospital and then three times a week at home. Now I am going to outpatient therapy twice a week. I do specific exercises 2–3 times a day at home in between outpatient visits.”

The recovery mindset is the same one everyone should have as they age, she says: Keep moving and stay active.

“As long as I do that, I will be back to my swimming and bike riding in due time.”

A better option is to start sooner in preventing problems that may occur later in life. Even for genetic problems, like osteoarthritis, there are a few strategies that can help prolong the onset of knee pain and problems. Check with your doctor before beginning any new strategies.

  • Exercise: Experts suggest walking or other low-impact exercises, but if running is your passion, you can continue to do it. Just remember that regular stretching and warm-ups are part of exercise, and you should take caution to reduce the risk of injuring your knees.

  • Maintain a healthy weight: Carrying extra weight stresses all of the body’s joints, especially the foundational joints like the ankles, hips and knees. Even a few extra pounds can increase the stress on your joints during normal daily activities.

  • Get up and move: If you work in a sedentary job, be sure to get up and move around frequently. Inactivity actually creates more knee problems, so use the 2-hour rule. At a minimum, get up every two hours and spend five minutes or more walking around to get your blood flowing. This also helps lubricate your joints and relieve stiffness.

  • Remember your age: Some baby boomers want to continue exercising and participating in sports with the same enthusiasm and intensity as they did during their younger years. Exercise is good for you, but as you age, it’s easier to overdo it and put undue stress on your body. Take your age into consideration and appropriately scale back your activities to help reduce the likelihood of injury.

If you do experience knee pain, try to prolong surgery as long as possible. Often, a combination of physical therapy and pain management can reduce or control the discomfort associated with degenerative knee issues.

Discuss your options for prolonging surgery with your orthopedist. The doctor may be able to perform lubricating or pain management injections that can put off the need for surgery for years. It may not be necessary to wait until the pain is debilitating, but waiting as long as possible reduces the likelihood that you’ll have to suffer through knee replacement surgery a second time.

Knee replacements are not simple surgeries. They’re invasive and painful, and will require weeks to months for complete recovery. The basics – exercise and weight management – will go a long way toward preventing or prolonging the need for a knee replacement.



Sources

Should I Really Worry About My Knees?” Susan Paul, September 2015, Runner’s World.

How to Prevent Knee Pain in Old Age,” February 2017, Arizona Pain.

Questions and Answers About Knee Problems,” March 2016, National Institute of Arthritis and Musculoskeletal Skin Diseases.

9 Things No One Ever Tells You About Getting a Knee Replacement,” Aviva Patz, July 2015, Prevention.

Knee Replacement and Revision Surgeries on the Rise,” Linda Rath, Arthritis Foundation.

Why More Americans are Getting Knee Replacements Nowadays,” Katie Osborn, September 2015, Money.

The Lowdown on the Uprise of Knee and Hip Replacements,” Kim Klugh, May 2012, Orthopedic Institute of Pennsylvania.

Blog posting provided by Society of Certified Senior Advisors
www.csa.us