Joint Replacement Archive

The number of total knee replacement (TKR) procedures performed on people in the Medicare system has grown dramatically, according to a study in the Journal of the American Medical Association. From 1991 to 2010, 3.2 million Medicare beneficiaries underwent either a first TKR or a replacement implant because of infections, implant failure or wear, or other complications. Medicare reimburses for TKRs at a rate of around $15,000 per knee.

One factor driving the implant upsurge is the desire of an aging population to remain physically active. Another factor is an increase in people who are overweight or obese, which causes joints (both natural and implanted) to wear out faster.

Choose wisely when considering surgical options.

When it's time to do something about the unbearable arthritis pain in your hip, you'll likely hear about an alternative to total hip replacement called hip resurfacing. The two procedures appear to have similar short-term results with regard to function and activity level, according to a new study in the journal BMJ. But be careful. "The long-term benefits haven't been shown at all," says Dr. Donald Reilly, assistant clinical professor of orthopedic surgery at Harvard Medical School.

Replacement vs. resurfacing

The hip is a ball-and-socket joint, where the thigh bone (femur) meets the pelvis bone. The ball is at the top of the femur, known as the femoral head, below which is the neck of the femur. The socket is the acetabulum, part of the pelvis bone. In a total hip replacement, the surgeon removes the damaged surface of the socket, the femoral head, and the neck of the femur, then replaces them with prosthetic components. In a hip resurfacing, the surgeon places a prosthetic cap on the femoral head, preserving the neck, and replaces the acetabulum. Resurfacing preserves the femur, which may make future hip surgeries easier. Insurance pays for both procedures and recovery time is the same: three days in the hospital, followed by 4–6 weeks of physical therapy.

Try these tips to get more life out of your own joints.

In the 1970s TV series The Bionic Woman, secret agent Jaime Sommers' legs and right arm were rebuilt with bionic parts after she was injured during a skydiving accident. The new parts came in handy when she needed to, say, outrun a pack of vicious dogs or jump rivers.

Today's high-tech procedure offers more benefits.

Here's another reason to get that knee replacement you've been debating: A new study presented at the 2012 Annual Meeting of the American Academy of Orthopaedic Surgeons finds that adults with osteoarthritis face lower odds of developing heart failure by having a total knee replacement. The study did not show a direct cause and effect or prove definitively that a total knee replacement (TKR) could improve cardiovascular health. However, the procedure does allow the recipient to exercise again, which can lead to better heart health.

And that's just one of the benefits of today's TKR.

Metal-on-metal hip replacements don't increase cancer

Dr. Donald T. Reilly is an orthopedic surgeon at New England Baptist Hospital and a long-time member of the Health Letter's editorial board.

How many knee and hip replacements have you done?

Q. I recently had a right hip replacement and my doctor says I'm now ready to use a cane. Do you have any recommendations about the best way to use it?

A. Congratulations on your progress! A proper cane can be very helpful. It will reduce pain by taking some of your body's weight off the hip. It can also improve your stability and balance and reduce the demand on muscles and tendons that might still be inflamed or weak after surgery. A cane will get you on your feet and allow you to be more active, helping you strengthen your body and giving you some independence while your hip heals.

Research we’re watching

A study found that knee buckling was associated with a higher risk of recurrent falls and significant injuries.

Knee buckling, caused by weakened muscles, is common in people who have osteoarthritis in their knees. To determine whether knee buckling leads to falls, researchers at the University of California, San Francisco, studied 1,842 participants enrolled in the Multicenter Osteoarthritis Study (MOST), 59% of whom were women. At a visit five years into the study, the researchers asked the participants if their knees had buckled in the past three months and whether they had fallen as a result. About 17% of participants said their knees had buckled, 20% of whom reported falling as their knees gave way.