RESEARCH - Boomers wear out artificial joints

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Boomers wear out artificial joints

study: Young recipients may end up on waiting lists twice

Sharon Kirkey, National Post

Published: Thursday, October 26, 2006

The youngest of the Baby Boomers are wearing out their joints at a record

pace, not because they're growing older but because they're getting fatter,

a new study suggests.

Across Canada, joint replacements are increasing faster than the population

is ageing, with hip and knee surgeries up 87% over a 10-year period ending

in 2004-2005.

Most joint patients are 65 and older, but the greatest increases for the

operations were in the 45-to-54-year-old age group, where the rate of knee

replacements more than doubled among men, and more than tripled for women.

Both genders in that age group saw a doubling in hip replacements.

Eighty-seven per cent of patients receiving artificial knees, and 74% of hip

patients, were overweight or obese. Joint patients " were rarely

underweight, " according to the report released yesterday by the Canadian

Institute for Health Information.

" We absolutely know that weight is associated with arthritis; we know

arthritis is the main diagnosis in hip- and knee-replacement surgery, " says

Margaret Keresteci, manager of clinical registries for the Ottawa-based

group.

Hospitals knew the bulge in demand for joints was coming, as ageing Baby

Boomers move through the system. But orthopedic surgeons call the increase

in younger patients -- and females in particular -- startling.

What's more, there will likely be another surge in demand as those new

joints wear out.

Most data on how long mechanical joints last come from people in their 70s,

who tend to be thinner and less demanding on their joints.

" Are we making a mistake, long term, by doing more and more patients at a

younger and younger age, with a higher and higher BMI? " asked Dr.

Dunbar, an orthopedic surgeon and director of orthopedic research at

Dalhousie University.

It's a bit of a chicken-and-egg argument, he says: " Patients tell me they

can't lose weight because their knees or hips are so bad they can't

exercise. "

Females appear more vulnerable than men to joint disease if they put on

weight because of their proportionately smaller bones. The majority of hip

(57%) and knee (60%) replacement patients were women.

In B.C., the problem may not be excessive weight, but excessive exercise.

The province with the lowest obesity rates in Canada saw the biggest

increase in knee replacements over 10 years.

Knee replacements were up 105% in B.C. over the 10-year study period, from

46.2 knee replacements per 100,000 population in 1994-95, to 94.9 per

100,000 population a decade later.

It may be a result of surgeons doing more volume. But, it's also true that

" there's a whole group out there, females in particular, who have had

sporting injuries, etc. that drive them to secondary osteoarthritis, " Dr.

Dunbar says. Osteoarthritis is wear and tear on the joints.

Overall, there were 58,714 hospitalizations for hip and knee replacements in

Canada in 2004-2005, a 10% increase over the previous year.

Joint replacement surgery was once limited to older people who, by the time

their artificial hip or knee failed, would be either infirm or dead.

" That's no longer the case, " Dr. Dunbar says. People are demanding new knees

and hips at younger ages.

" They say, 'I don't want you to tell me when I can have my quality of life.

I want to have it now while I'm young so I can enjoy my kids, not when I'm

65 and I don't know what the world's going to be like in the next 20 years

anyways.' "

P.E.I. and Saskatchewan had the highest, age-adjusted rate of hip

replacements, while Newfoundland, Labrador and Quebec had the lowest.

However, the greatest per cent increase was in Quebec (33%) followed by

Newfoundland and Labrador and B.C. (28% each).

Treatment has also changed. Minimally invasive surgery, with its smaller

incisions and faster recovery times, is up, and hospital stays are down. The

average length of stay for a hip replacement was nine days in 2004-2005,

down from 14 days a decade earlier.

Prime Minister Harper has promised shorter waiting-time guarantees

for artificial hips and knees.

" The message can't be from this, 'Look at all the joints we've done, what's

the problem?' We're just catching up appropriately and we're not even really

cracking where we need to be for this very, very successful intervention

that can radically change someone's life, " says Dr. Dunbar, chair of the

scientific advisory committee for the Canadian Joint Replacement Registry.

Doctors are predicting almost a doubling in demand for joint replacement

over the next 10 to 20 years just as more surgeons are set to retire. " It's

a bit of a perfect storm, " he says.

http://www.canada.com/nationalpost/news/story.html?id=9107feb7-6962-456b-bdaa-86\

01eea293ae & k=26407

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org