"The number of patients in their 50s coming into my office asking for joint replacement is higher than ever," says Dr. Steven B. Haas, a knee surgeon at Hospital for Special Surgery in New York City.
At Special Surgery, where more knee replacements and hip surgeries are performed than at any other hospital in the nation, doctors are looking at what happens when their patients go back to the sports they love. To meet the growing need, Hospital for Special Surgery orthopedists like Dr. Haas have collaborated on new devices with more wear-resistant materials so patients in their 50s may not have to worry that a new knee will wear out before they will.
"Joint replacement used to be about doing the things you needed to do -- literally, being able to walk. Now, younger patients are coming and saying, 'I want to continue playing tennis, skiing, golfing, or coaching little league and don't want to be sidelined by pain or disability,'" says Dr. Haas, who is chief of the knee service at Hospital for Special Surgery. Earlier this year, he presented the outcomes of his research on a newer knee design and showed that most patients can comfortably perform these activities. Additionally, the FDA has recently approved an implant referred to as the "30-year knee," which was based on tests simulating 30 years of use.
Across the United States, baby boomers' passion for competing in marathons, triathlons, basketball and tennis has worn out knees, hips and shoulders in middle age. As a result, this group is undergoing joint replacement sooner to get on with their lives. At Hospital for Special Surgery, 27 percent of knee replacements in 2009 were for people under the age of 60.
Only a few years ago, joint replacements were performed on individuals in their 60s and 70s because it was thought that implants wouldn't last more than 15 to 20 years. As a result, patients were encouraged to postpone these procedures so they wouldn't need to have a second replacement.
A number of studies of knee and hip replacements have shown that after 20 years, 90 percent are still functioning. Today's new devices may extend the implant's life expectancy even further.
All this was good news for Jane Byron, age 51, a nurse who underwent knee replacement surgery in both knees in 2010. An extremely active person, Jane is on her feet at work and exercises at the gym seven days a week. Six years ago she had a rollerblading accident and tore her meniscus. She was told at the time that she also had arthritis and needed a knee replacement. She went for a second opinion and was told that she wasn't ready for one. Instead, she had arthroscopic surgery to repair the meniscus and then underwent Synvisc injections. Jane noticed that she began to walk cockeyed and her leg became very knock-kneed and deformed. Her knee wasn't functioning right and she was using all of her body strength to keep herself mobile and upright.
Five years following her initial accident, she sought help at Hospital for Special Surgery where she met with Dr. Haas. He recommended a minimally invasive knee replacement. Two days following surgery, Jane walked with a cane to the gym where she did an upper body workout. Because she had placed so much stress on her "good" knee, she damaged it as well and Dr. Haas advised that it be replaced too. Jane underwent a second knee replacement four months later. The day following surgery, she mounted a Lifecycle and pedaled for 45 minutes. She's ridden the bike daily ever since. Two months post-surgery, she was pressing 75 pounds on the squat rack.
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