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Operating trend

Baby boomers fueling increase in number of knee and hip surgeries

June 12, 2011
By RODNEY MINOR , The Leader Herald

Before having surgery on her sore hip, Jacque Bresonis recalled, at times, the pain was so bad she would question doing small tasks such as walking to a different room in her house.

However, about a year removed from the procedure, the 65-year-old Fort Johnson resident said she almost is fully recovered.

"[The procedure] fully met my expectations," she said.

Article Photos

Joe Thomas, an operating room technician, and Dr. Russell Cecil, an orthopedic surgeon at Mohawk?Valley Orthopedics in?Amsterdam, work on a patient at St. Mary’s Hospital in?Amsterdam on?Thursday.
The Leader-Herald/Rodney Minor

Bresonis is part of a growing trend of baby boomers getting operations to fix their bones and joints at earlier ages than their parents often did.

Knee-replacement surgeries have doubled over the last decade and more than tripled in the 45-to-64 age group, new research shows. Hips are trending that way, too.

It's not all due to obesity. Ironically, trying to stay fit and avoiding extra pounds is taking a toll on a generation that expects bad joints can be swapped out like old tires on a car.

"Boomeritis" or "fix-me-itis" is what Dr. Nicholas DiNubile, a suburban Philadelphia surgeon, calls it.

"It's this mindset of 'fix me at any cost, turn back the clock,'" said DiNubile, an adviser to several pro athletic groups and a spokesman for the American Academy of Orthopaedic Surgeons. "The boomers are the first generation trying to stay active in droves on an aging frame" and are less willing to use a cane or put up with pain or stiffness as their grandparents did, he said.

Bresonis said she - along with many of her fellow baby boomers - have spent a lifetime being active and exercising.

Everyday, Bresonis said, she walks, works out on an elliptical cross trainer or plays golf.

A little more than two weeks after the hip procedure was done, Bresonis said she was able to go out and play 18 holes of golf.

"We want to stay active, be careful about our weight and stay in shape," she said.

The procedure Bresonis underwent is called a Birmingham Hip Resurfacing, which is different than a total hip replacement. The resurfacing surgery involved a smooth metal cap being placed over the head of the femur, while a matching metal cup was placed in the pelvis socket. Very little bone is removed compared to a traditional total hip replacement.

Dr. Russel Cecil, an orthopedic surgeon at Mohawk Valley Orthopedics in Amsterdam who also does work at St. Mary's Healthcare, performed the operation for Bresonis.

Cecil said many of the baby boomers he has as patients still want to remain active despite their bad joints. They want a high performance joint replacement, he said, something that will give them more stability, range of motion and require a less invasive procedure.

He noted the technology used in the field has evolved over the years to help make such procedures possible.

In addition to the hip resurfacing, for example, Cecil said when he started years ago a hip replacement procedure involved a surgeon taking out a saw and "eyeball" the cut that needed to be made on a bone.

Now, computer software can look at a 3D model of the patient's joint and show the surgeon exactly where to cut. This has led to a less invasive procedure that is faster and yields better results, he said.

However, Cecil said, procedures such as hip and knee replacements are still major surgeries that are not undertaken lightly.

As an example, he said, for people in their 40s with a mild degree of arthritis in a knee, it will probably not be worth it to perform the procedure. People need to have severe arthritis to feel better and really benefit from a joint replacement, he said.

Besides the usual risks of surgery - infection, blood clots, anesthesia problems - replacing joints in younger people also increases the odds they'll need future operations when these wear out, specialists say.

"We think very carefully about patients under 50" and talk many of them out of replacing joints, said Dr. William Robb, orthopedics chief at NorthShore University HealthSystem in suburban Chicago.

Cecil said that ultimately, no replacement is as good as a normal human knee. Unless there will be a worthwhile improvement, it is not worth replacing the joint.

There were 288,471 total hip replacements performed in the U.S. in 2009, nearly half of them in people under 65, according to the federal Agency for Healthcare Research and Quality, which tracks hospitalizations.

Knee replacements soared from 264,311 in 1997 to 621,029 in 2009, and more than tripled in the 45-to-64-year-old age group.

"Five or 10 years ago, a very small number of people under 65 were receiving this surgery. Now we see more and more younger people getting it," said Elena Losina, co-director of the Orthopaedic and Arthritis Center for Outcomes Research at Brigham and Women's Hospital in Boston.

She analyzed how much of this rise was due to population growth and obesity, and presented results at an orthopedic meeting in San Diego in February.

From 1997 to 2007, the population of 45- to 64-year-olds grew by 36 percent, but knee replacements in this group more than tripled. Obesity rates didn't rise enough to explain the trend.

"At most, 23 percent of the 10-year growth in total knee replacement can be explained by increasing obesity and population size," Losina said.

Bresonis said she plans to stay active, like many of her fellow baby boomers.

"Sixty-five isn't what we thought it would be," she said.

Information from the Associated Press was used in this story.



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