Big boom in boomer knee replacement surgeries

U-M experts say huge growth in need far outpaces availability of surgeons





ANN ARBOR, Mich. – John Birko’s knee had osteoarthritis, was painful, and severely limited his day-to-day activities.

While his knee felt as though it was about 80 years-old, Birko was only 49. And like many other baby boomers today, he was not was ready to slow down, and instead decided to have knee replacement surgery.

“Having knee replacement surgery made an extraordinary difference in my life,” says Birko, who is now 51 years-old. “The day after surgery, I felt terrific. I had forgotten what it was like to not be in pain. I was on top of the world.”

The number of baby boomers who are opting for knee replacement surgery earlier in life is growing at an exponential rate, says J. David Blaha, M.D., an orthopaedic surgeon at the University of Michigan Health System.

Only a few years ago, between 300,000 and 350,000 knee replacement surgeries were being done. Today, that number has risen to a staggering 500,000. And 10 years from now, experts estimate there could be as many as 3.2 million annual knee replacement surgeries.

While knee replacement surgery does have a positive impact on a patient’s quality of life, Blaha and other experts in the field worry that the demand for new knees will far outpace the availability of surgeons trained to perform the procedure.

“A recent study that looked at trends in joint replacement found that although the number of orthopaedic specialists who do joint replacement is going to increase by about 2 percent, the need for orthopaedic surgeons is going to increase by 500 percent,” he says. “That’s a problem of epic proportions.”

The reason for the increase can be attributed to baby boomers wanting to maintain an active lifestyle. Previously, Blaha notes, knee replacement surgeries were reserved for very old patients who were severely crippled by osteoarthritis.

But younger patients like Birko – who tore his ACL and cartilage when he was a teenager and later injured his knee again while playing sports – are experiencing an earlier onset of osteoarthritis that affects their daily lives.

Today, degenerative arthritis remains the main reason for joint replacement surgery. Degenerative arthritis is a chronic disease that causes the cartilage at the end of the bones to deteriorate, bringing with it pain and a decrease in joint function. Without a means to replace cartilage in knees, total knee replacement remains the only option to regain mobility and end pain

Fortunately, knee replacement surgery has come a long way in recent decades, and is now far less painful and the recovery is much faster.

With knee replacement surgery, the ends of the damaged thigh, lower leg bones and often the kneecap are capped with artificial surfaces lined with metal and plastic. Usually, doctors replace the entire surface at the ends of the thigh and lower leg bones.

Although knee replacement surgery allows patients to do many of their daily activities more easily, Blaha says surgeons still don’t have a good estimate for how long knee implants will last – especially now since so many patients are getting new knees at a younger age.

“We want joint replacements to last for more than 20 years. But one of the problems is, that no matter how good we get with statistics, it still takes 20 years to get 20 year results,” says Blaha, professor, Department of Orthopaedic Surgery at the U-M Medical School. “So we’re faced with a young population that is in its 50s, and has the opportunity to live into its 80s and 90s. They want their joint replacements to last 30 to 40 years, and we just don’t know yet if that will happen.”

One way to avoid needing a knee replacement is to take steps to prevent degenerative arthritis. Since obese people have a higher incidence of degenerative arthritis, Blaha recommends maintaining a healthy body weight and taking steps to stay active at any age.