More Than 4 Million Americans Have New Knee

FRIDAY, Feb. 10 (HealthDay News) — More than 4 million Americans
now live with an artificial knee, and increasing numbers of younger
patients are undergoing knee replacement surgery, new research
reveals.

Researchers at Brigham and Women’s Hospital in Boston estimate that
more than half of adults who are diagnosed with knee osteoarthritis will
receive a total knee replacement in their lifetime.

Senior author Elena Losina, co-director of the hospital’s Orthopaedic
and Arthritis Center for Outcomes Research, said the country’s aging
population and high rates of obesity are only partly responsible for the
rise in total knee replacements.

“We think that as more and more people began participating in active
sports, they sustained injuries earlier in life, and therefore developed
knee osteoarthritis earlier,” Losina said. “And these active people are
probably more willing to undergo surgery that will enable them to continue
to be active.”

Also, with improved success rates over the past 20 years, “surgeons are
more comfortable offering it, and patients are more comfortable having
it,” Losina added.

A shorter postoperative hospital stay has also made the procedure more
acceptable, she said. “Ten or 15 years ago, patients stayed in the
hospital for a week,” Losina said. “Now, they’re usually discharged on the
third day after surgery.”

The number of new-knee procedures doubled over the last decade, reached
more than 620,000 in 2009, and the researchers said younger patients —
those 45 to 64 — accounted for a disproportionate amount of that growth.
Their relatively young ages means many are at risk of revision surgery as
well as potential long-term complications of surgery, the authors
warned.

The researchers estimate that more than 4.2 million Americans currently
have an intact total knee replacement, which represents 4.4 percent of the
total population aged 50 and over. Prevalence is slightly higher in women
versus men.

They further estimate that nearly 53 percent of men and 52 percent of
women diagnosed with symptomatic knee [osteoarthritis] will receive a
total knee replacement in their lifetimes. The risk of subsequent revision
is nearly 15 percent for men and roughly 18 percent for women, the authors
wrote.

In osteoarthritis of the knee, the cartilage wears down, causing
changes in the adjacent bone, resulting in pain, swelling and
stiffness.

The study is scheduled for presentation Friday at an American Academy
of Orthopaedic Surgeons’ meeting in San Francisco. The researchers’ data
included information from the U.S. Census, two national studies on people
with knee arthritis, and a computer model on the history and management of
knee arthritis.

One leading orthopedic surgeon, Dr. William J. Robb III, chairman of
the department of orthopaedic surgery at NorthShore University Health
System in Evanston, Ill., said the findings were useful in that they
provided more details about the number of patients now living with
artificial knees. But he questioned the estimate of patients who might
require revision surgery.

“The study used historical failure and complication rates to predict
future numbers of failures that might require revision surgery,” Robb
said. “The methodology used likely projects the ‘worst-case scenario’ for
total numbers of failures, as implant materials have been improved and
those improvements may decrease the overall revision rate.”

The study was funded by the U.S. National Institutes of Health’s
National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Data and conclusions presented at medical meetings should be viewed as
preliminary until published in a peer-reviewed medical journal.

More information

To learn more about total knee replacements, visit the American
Academy of Orthopaedic Surgeons
.

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