Wednesday, January 15, 2014

Total Joint Replacements - The Surgeon Says I Am Too Young


In the United States today there are more cases of osteoarthritis also known as degenerative joint disease reported then ever before. In fact there are roughly 21 million people affected by it in the US in one form or another. It is estimated that 27% of the visits made to the primary care doctors in this country are attributed to osteoarthritis. There are numerous factors that contribute to the high incidence of arthritis. Included are obesity and the fact we are living longer. The diet we consume here in the west has also been blamed for the steady increase of arthritis along with, the lack of exercise and maintaining strength in the weight bearing muscles of the hip girdle, quadriceps and gluteal muscles just to name a few.

There are over 100 types of arthritis known in the medical community but the one that is the most predominant is osteoarthritis. Osteoarthritis not only weakens or atrophies the surrounding musculature around the affected joint but it also causes a marked decrease in the range of motion due to to the pain it causes with movement. Its a cycle that if not corrected will steadily add to the loss of function and quality of life.

It can affect all joints within the body but the area it is seen the most is the weight bearing joints such as the hips and knees. With arthritis in these joints walking now can become very painful depending on the progression of it. Once the joint becomes bone on bone walking effectively now becomes your biggest issue along with missing a good nights sleep as it will cause a mild chronic ache along with muscle spasms depending on the position of the joint while lying in bed.

Total joint replacement with hips and knees continue to be on the rise along with, orthopaedic surgeons seeing younger individuals where pain becomes unbearable and the replacement surgery is all that will give the patient relief. With the aging of the baby boomer the typical patient also is more active then previous generations causing an earlier incident of arthritis which can brought on quicker through previous injuries to your knees or hips.

Not to long ago finding a surgeon that was willing to replace a joint when someone was in their forties or fifties was difficult but today more orthopaedic surgeons are willing to recommend a replacement if conservative options such as physical therapy have been unsuccessful.

Once treatments with a physical therapist have not given the patient relief its time to consider getting the joint replaced as soon as possible. By continuing to live with the chronic pain either the patient has to live on a continual dose of pain medication or continue to lose what mobility they have.

By becoming deconditioned and allowing further muscle and soft tissue contractures to begin to develop, only causes further problems during the rehabilitation process.

By finding a surgeon that is willing to replace the joint allows you to get back on your feet and live your life without the discomfort that is associated with osteoarthritis. And if you live a normal lifespan you will have to have a revision done as the joint replacement will not last forever.

How long the original replacement will last will depend on your age, body weight, level of fitness and overall health. This is one of the big reasons that originally kept surgeons from wanting to complete a joint replacement on anyone under the age of fifty to start with. It was felt at one time that the original replacement would have the best outcome. The revision would not fair as well due to the fact there would be further surgical removal of bone and soft tissue causing greater difficulty in movement, pain relief, etc.... and the fact that when the patient is younger they will be much harder on the replacement then if they were older and not as active.

Today with the rapid advancement of technology in materials used in medicine that have become more bio friendly and, joint prosthesis that have started to mimic more of the rotational components of the human joint, will allow the original replacements to have a longer shelf life.

No longer should their be a case where you are being told that you are to young for a joint replacement. You and the surgeon will want to thoroughly discuss your options of course.
Conservative treatment will initially will be your first course of action to decrease pain and regain strength in the affected joint.

Once all avenues of conservative treatment have been pursued and relief has not been successful then is the time to get the joint replaced no matter what your age is. By postponing surgery due to age only will complicate matters in your quality of life and rehabilitation.

There are now today multiple prosthesis models available that your surgeon will recommend for your current lifestyle as your surgeon will have some sort of track record to go with in regards to what components are more successful then others.

If a total joint is needed and recommended then it is highly advised to get it done. I had a knee replaced at 43 years of age and never regretted that decision.

Richard Haynes
Punta Gorda, Florida

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