Big Jump in Knee Replacement Surgery
Younger patients are a result of the obesity epidemic, experts say.
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WASHINGTON — WEDNESDAY Nov. 9, 2011 (MedPage Today) —Knee replacement surgery among middle-aged men and women increased 2.5-fold from 1997 to 2009, new figures from the Agency for Healthcare Research and Quality (AHRQ) show.
The rate of hospitalizations for knee arthroplasty for women ages 45 to 64 increased 157 percent, from 16 per 10,000 people in 1997 to 42 for every 10,000 people in the U.S. in 2009.
For men, the rate jumped 144 percent, from 11 stays to 28 stays per 10,000 people over the same time period, according to a report released last week by AHRQ on statistics in hospital-based care.
In 2009, knee arthroplasty was the 14th most common inpatient hospital procedure.
The rates for older women and men — those who are 65 to 84 — also increased markedly, by 69 percent for women and 55 percent for men, from 1997 to 2009. Among those 85 and older, rates of hospitalization for knee surgery increased by 23 percent for women and 36 percent for men during the same time period.
Overall, the rate of hospital stays for knee arthroplasty increased 84 percent, from 12 per 10,000 population in 1997 to 22 per 10,000 population in 2009.
While the AHRQ report didn't speculate on reasons for the increase in knee replacements, a researcher from Florida International University said in a 2008 article in the journalArthritis Care & Researchthat the increase in the procedures in pre-Medicare age population may be due to an increasingly obese population.
That study found that the number of total primary knee replacements grew from 264,331 in 1997 to 431,485 in 2004. Revision knee replacements also increased over the same time period.
Frank Kelley, MD, an orthopedic surgeon in Macon, Ga. — who was not involved in either study — agreed that obesity may be partly to blame for the increase in knee replacement surgeries.
"In my own patients, yes, it sure seems like that's true," he toldMedPage Today. "Obviously obesity rates are increasing. Probably because of the obesity epidemic, there is an increased incidence of arthritis at early age."
Kelley said advancements in the field — more precise surgery and more durable implants — also have contributed to more people deciding to have knee surgery.
"The results from total knee replacement are much more reliable and replicable than they were a decade ago," he said.
In 1997, patients were told their replacement knee would be good for 10 to 15 years. Knowing that they would likely have to undergo another major surgery a decade down the road may have been a deterrent, Kelley said. But now, Kelley tells his patients they can expect the artificial knee to last 20 years.
"They're more willing to have something done in their 50s if they know they'll be in their 70s or early 80s before they have to have it redone," he said.
In addition, the technique for knee replacement is less invasive that it used to be, and recovery time is shorter, said Kelley, who had his own knee replaced at age 59.
Video: Riverside Methodist offering a new Knee replacement surgery with implants tailored to fit women.
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